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Background: Extraction of impacted third molars is a standard procedure in dentistry. However, the postoperative inflammation and pain are undesired and uncomfortable. Methylprednisolone has emerged as a possible solution to improve outcomes. This systematic review aimed to evaluate methylprednisolone in the postoperative period of impacted third molars in relation to its efficacy in postoperative pain and edema, dosage regimens, administration forms, and adverse effects., Material and Methods: Following the PRISMA guidelines, the focus question was: "In patients who underwent impacted third molar extraction, what was the effect of methylprednisolone used postoperatively compared to non-use or the use of other medications within the same pharmacotherapeutic group to reduce inflammation and pain?" PubMed/MEDLINE and Scopus were consulted, and an additional manual was performed. The search included articles published in the last 10 years, with the language restriction to English. The articles were analyzed using the PRISMA principles, with pre-defined eligibility criteria. The data were extracted based on the general necessary information. The risk of bias for the RCTs included was performed using a revised Cochrane risk-of-bias tool for randomized trials, and a meta-analysis was performed., Results: Nine articles were included, and five were quantitatively analyzed. Evaluating the test and control groups (methylprednisolone versus controls), there was no significant heterogeneity for pain at 24 hours (p=0.15, I²=47%) and 7 days (p=0.15, I²=47%), with non-significant effects (p=0.85). In the inter-incisal reduction, there was homogeneity at 48 hours (p=0.96, I²=0%) and 7 days (p=0.37, I²=0%), with a greater reduction in the methylprednisolone group (p<0.01 and p<0.05, respectively)., Conclusions: Methylprednisolone is efficient in safely treating patients after third molar extraction, reducing pain, edema, and trismus. It achieved better results for the inter-incisal level than dexamethasone; otherwise, dexamethasone is preferable in minimizing postoperative trismus, presenting superior potential in this specific clinical context.

Background: The use of low-level laser is a therapeutic resource that has been widely used in medicine in general, which has properties capable of modulating inflammatory effects such as pain, edema, and trismus resulting from oral surgeries for the extraction of impacted third molars. This study aimed to evaluate the effect of laser therapy at two different wave frequencies (660nm and 808nm) in patients undergoing impacted 3rd third lower molar extraction. For this, 30 patients were selected and randomly distributed into three groups with 10 individuals each (Control Group, 660nm Group, and 808nm Group)., Material and Methods: Each participant, according to their experimental group, received irradiation before the start of each surgery and immediately after the surgical procedure. The data regarding edema, pain intensity, and trismus collected before the surgeries, immediately after, and after seven days were spreadsheeted and analyzed to determine the mean and standard deviation. After the Shapiro-Wilk normality test, differences between the experimental groups were determined using Multiple Analyses of Variance, considering a significance level of 5% (p<0.05)., Results: The results showed no statistically significant difference between the experimental groups in the analyzed items. Despite this, both groups irradiated with 660nm and 808nm frequencies experienced a reduction in the perception of postoperative pain, thus suggesting the benefit of using low-power laser therapy as an adjunct in the surgical treatment of impacted lower third molars., Conclusions: Despite the results showing no differences between the groups, using LLLT resulted in lower pain perception in the irradiated participants compared to those in the control group. This fact supports the use of LLLT as an adjuvant therapy in patients undergoing oral surgery procedures to remove impacted third molars.

Objectives: The present study compared two implants with different macrogeometries placed in healed alveolar sites, evaluating the insertion torque (ITV) and implant stability quotient (ISQ) values at three different periods. Methods: Seventy patients with a total of 100 dental implants were allocated into two groups (n = 50 per group): DuoCone implants (DC group) that included 28 implants in the maxilla and 22 in the mandible, and Maestro implants (MAE group) that included 26 in the maxilla and 24 in the mandible. The ITV was measured during the implant placement, and the ISQ values were measured immediately at implant placement (baseline) and after 30 and 45 days. Results: The mean and standard deviations of the ITV were statistically significant (p < 0.0001), 56.4 ± 6.41 Ncm for the DC group and 29.3 ± 9.65 Ncm for the MAE group. In the DC group, the ISQs ranged between 61.1 ± 3.78 and 69.8 ± 3.86, while the MAE group presented similar values compared with the other group, ranging between 61.9 ± 3.92 and 72.1 ± 2.37. Conclusions: The value of implant insertion torque did not influence the ISQ values measured immediately after implant placement. However, the ITV influenced the ISQ values measured in the two initial periods of osseointegration, with implants installed with lower torques presenting higher ISQ values.

Gingival recession is a common manifestation in most populations. The mechanism by which gingival recession occurs is not well understood, but it seems to be complex and multifactorial. The main etiological factors are the accumulation of dental plaque biofilm with the resulting inflammatory periodontal diseases and mechanical trauma due to faulty oral hygiene techniques, especially in thin biotypes. This case report describes the treatment of a vestibular recession associated with interdental bone loss, with the VISTA technique associated with a connective tissue graft. The case was evaluated at 3, 9 months and 48 months after the surgery clinically complete root coverage and increased thickness of keratinized tissue were achieved, and the interdental papilla was augmented improving the soft tissue quality for future orthodontic treatment. VISTA technique associated with a connective tissue graft to reconstruct vertically papilla is a promising alternative for minimally invasive treatment and stable after 4 years., Competing Interests: None

The goal of this overview was to systematically verify the best available literature on surgical and nonsurgical treatments of peri-implantitis to determine evidence-based treatment protocols for peri-implantitis. Three databases (MEDLINE/PubMed, Web of Science, and Cochrane Library/Evidence) were searched by two independent reviewers, including systematic reviews (SRs) that involved randomized controlled trials (RCTs). The search was limited to articles between January 2014 to January 2021 with an English language restriction. In total, 437 articles were initially found, of which only 34 were selected for full-text reading. Nine SRs were included in this study, enrolling 59 different RCTs. Some studies investigated both surgical and nonsurgical techniques, while others focused on only one approach or the other. In total, six of the studies included nonsurgical techniques, and eight included surgical techniques (ie, augmentative, regenerative, and corrective/resective techniques). Nonsurgical interventions appeared to offer some degree of clinical improvements, especially in bleeding on probing levels, but they were not enough to fully treat peri-implantitis. Whereas surgical techniques seemed to be more effective in improving overall clinical parameters, especially probing depth, bleeding on probing, and to some extent, marginal bone level, no specific surgical technique or material (graft or membrane) had a clear advantage over others. Therefore, resective surgical and implantoplasty techniques demonstrated significant improvements in clinical parameters. Although surgical interventions are more indicated to treat peri-implantitis than nonsurgical procedures, the predictability is still a concern due to titanium particles scattered within the local tissue.

Objectives: This study aimed to compare clinical results between titanium (Ti), zirconia (Zr), or titanium-zirconium (TZ) dental implants and to analyze survival rate (SR), bleeding on probing (BoP), marginal bone loss (MBL), and/or probing depth (PD)., Data Source: Manual and electronic searches were conducted (PubMed and Web of Science) to identify randomized controlled trials that compared the outcomes of at least two implant types (control and test group) within the same study. The focused question was determined according to the PICOT strategy. Seven studies were included out of 202 research studies initially found. The follow-up periods ranged from 12 to 80 months, and the mean age was from 43.3 to 65.8 years old. The SR for Ti, TZ, and Zr implants ranged from 92.6% to 100%, 95.8% to 100%, and 87.5% to 91.25%, respectively; MBL for Ti, TZ, and Zr implants varied from -1.17 mm to -0.125 mm for Ti, -0.6 mm to -0.32 mm for TZ, and -0.25 mm to -1.38 mm for Zr. Studies showed a low incidence of mucositis and peri-implantitis; however, BoP for Zr was 16.43%, Ti ranged between 10% and 20%, and TZ from 10% to 13.8%. PD for Ti ranged from 1.6 mm to 3.05 mm, TZ was 3.12 mm (only one study), and Zr ranged from 2.21 mm to 2.6 mm., Conclusion: All three types of implants showed similar tissue behavior. However, the TZ group had better results when compared with Ti and Zr for SR, MBL, and BoP, except for PD. Furthermore, the worst SR was found in the Zr implants group.

Predictable outcomes intended by the application of PRF (platelet-rich fibrin) derivative membranes have created a lack of consideration for their consistency and functional integrity. This study aimed to compare the mechanical properties through tensile strength and analyze the structural organization among the membranes produced by L-PRF (leukocyte platelet-rich fibrin), A-PRF (advanced platelet-rich fibrin), and A-PRF+ (advanced platelet-rich fibrin plus) (original protocols) that varied in centrifugation speed and time. L-PRF (n = 12), A-PRF (n = 19), and A-PRF+ (n = 13) membranes were submitted to a traction test, evaluating the maximum and average traction. For maximum traction, 0.0020, 0.0022, and 0.0010 N·mm−2 were obtained for A-PRF, A-PRF+, and L-PRF, respectively; regarding the average resistance to traction, 0.0012, 0.0015, and 0.006 N·mm−2 were obtained, respectively (A-PRF+ > A-PRF > L-PRF). For all groups studied, significant results were found. In the surface morphology observations through SEM, the L-PRF matrix showed a highly compact surface with thick fibers present within interfibrous areas with the apparent destruction of red blood cells and leukocytes. The A-PRF protocol showed a dense matrix composed of thin and elongated fibers that seemed to follow a preferential and orientated direction in which the platelets were well-adhered. Porosity was also evident with a large diameter of the interfibrous spaces whereas A-PRF+ was the most porous platelet concentrate with the greatest fiber abundance and cell preservation. Thus, this study concluded that A-PRF+ produced membranes with significant and higher maximum traction results, indicating a better viscoelastic strength when stretched by two opposing forces.

Purpose: The goal of this study was to assess the effect of a liquid platelet-rich fibrin (PRF)-coated implant surface (double acid-etched) on osseointegration, analyzing the stability and the possibility of shortening the rehabilitation period., Materials and Methods: Initially, the blood was centrifuged to obtain the liquid PRF (2,000 revolutions per minute [rpm], 10 minutes), dividing a sample to be analyzed by Luminex, and another was applied onto the implant surface. Fifteen patients (30 implants) were divided into two groups (control and liquid PRF). Following the recommendation provided by the manufacturer, within a controlled torque at a maximum of 34 N.mm, the implant was placed. All patients had 1 year of follow-up., Results: Eleven analytes were identified for the sample characterization (IP-10, eotaxin, RANTES, macrophage inflammatory protein 1-beta [MIP-1β], VEGF, PDGF-BB, bFGF, IFN-γ, interleukin [IL]-5, IL-10, and IL-15). Regarding clinical evaluation, for control and liquid PRF groups, respectively, (1) the mean torque for implant placement was 26.67 and 27.27 N.mm; (2) the initial stability (implant stability quotient [ISQ]) was 64.87 (SD ± 6.01) and 67.36 (SD ± 7.21); (3) the final ISQ was 67.67 (SD ± 6.13) and 70.14 (SD ± 6.40); (4) it took an average 73 and 71 days to reestablish the masticatory function; (5) the survival rate was 93.3% and 86.6%; and (6) the marginal bone loss was up to 1.0 mm after 1 year (control)-for two patients, it was between 1.0 and 2.0 mm, and for another two subjects, it was up to 1 mm (liquid PRF). No statistical significance was observed for all parameters analyzed (P > .05)., Conclusion: Within the limitations of this study, the results indicated that there was no statistical significance when liquid PRF was applied on the implant surface, for all parameters.

Systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are influenced by genetic variants in immune system HLA genes. The Class II Major Histocompatibility Complex Transactivator (CIITA) is an important co-activator of the HLA transcriptional complex; the single nucleotide variant (SNV) rs3087456 localized in the gene promoter region (-168 A/G) has been reported as able to modify its transcription level. In our study, we assessed CIITA rs3087456 SNV in 1,044 Brazilians from two Brazilian regions (Northeast and South) to verify the association with susceptibility and clinical manifestations of (SLE) and (RA) using TaqMan SNP Genotyping Assays System. We observed a protection for a recessive model (GG x AA+AG) for RA susceptibility and increased risk for erosion development in AG genotype patients. No significant association was observed for SLE susceptibility; however, we observed significant increased risk for Class IV and V nephritis development in G allele and GG genotype patients. In conclusion, we showed the contribution of CIITA rs3087456 to SLE or RA clinical features and RA susceptibility in the studied populations., (© 2021 John Wiley & Sons Ltd.)

The objective of this study was to evaluate a new design of multifunctional abutment for Morse taper implant connections, relative to the retentive stability after the application of cyclic loads in cemented and screwed crowns. Multifunctional abutments with two different angulations in the seating portion of the crown were tested, forming 2 groups (n = 30 samples per group): Group Abut11, where Smart abutments with an angle of 11.42° were used; Group Abut5, where Ideale abutments with an angle of 5° were used. Fifteen samples from each group received cemented crowns (CC) and another fifteen screwed crowns (SC). All crown samples were subjected to the mechanical cycling test at 360,000 cycles at a frequency of 4 Hz and 150 N of the load. The samples with CC were subjected to the tensile test to remove the crowns, while in the samples with SC, the detorque value of the fastening crown screws was measured. The mean tensile strength value of CC in the Abut11 group was 131.9 ± 13.5 N and, in the Abut5 group was 230.9 ± 11.3 N; while the detorque mean value in samples with SC 5.8 ± 1.8 N for the Abut11 group and, 7.6 ± 1.1 N for Abut5 group. Significant statistical differences were found between the two groups in both situations tested (p < 0.05). The multifunctional abutments, presenting a lesser angulation of the crown-seating portion, showed higher values of retention of the CC and a lesser screw loosening of torque of the fixing screws in the SC after the application of cyclic loads when compared to the abutments with more angulation in the crown-seating portion., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: The purpose of this study was to provide sufficient information on the clinical outcome of zirconia implants, mainly observing the survival rate and marginal bone loss (MBL), with a minimum follow-up of 12 months, to verify the adoption of ceramics as a rational possibility for dental implants., Materials and Methods: A systematic electronic search through the PubMed (MEDLINE) and EMBASE databases was performed by two independent reviewers to identify clinical studies published between January 2005 and April 2019 containing a minimum of 10 patients per study and 12 months of follow-up after functional loading. References from the selected articles were manually reviewed for further studies., Results: From the initial 1,225 articles retrieved, 19 met all the inclusion criteria. The marginal bone remodeling accounted for mean losses of 0.8 mm (95% CI: 0.60 to 1.00 mm) and 1.01 mm (95% CI: 0.72 to 1.29 mm) at 1 year and 2 years postloading, respectively. The failure rate of 6.8% was calculated for a mean follow-up period of 2.75 years, where the prevalence of early failure, late failure, and implant fracture was 3.4%, 1.7%, and 1.7%, respectively. The meta-analysis associated with the survival rate of one- and two-piece zirconia dental implants was hindered due to the lack of confidence interval or standard deviation information in most of the included articles., Conclusion: Zirconia implants presented MBL values consistent with the standard in the global consensus, high survival rates, and considerable clinical results at short-term observation periods following prosthetic delivery.

Introduction: In Brazil, glomerulopathies are the third leading cause of chronic renal disease, accounting for 11% of dialysis patients. Studies on the prevalence of this disease in Northeastern Brazil are scarce., Objective: The aim was to describe the findings of biopsies and to conduct a comparative analysis on the clinical laboratory presentation of primary glomerulopathies (PG) and secondary glomerulopathies (SG)., Methods: This was a retrospective study conducted at two public teaching hospitals in the state of Pernambuco, Northeastern Brazil., Results: A total of 1151 biopsies performed between 1998 and 2016 were analyzed. The sample consisted of 670 biopsies of native kidneys, after excluding extra glomerular diseases and unsuitable material. PG were more frequent than SG (58% vs. 42%). There was a prevalence among PG of focal segmental glomerulosclerosis (43%). Membranoproliferative glomerulonephritis and collapsing glomerulopathy, accounted for 9% and 3% of the PG, respectively. For SG, the main etiologies were lupus nephritis (67%) and infections (10%). Female sex, hematuria and an elevated level of creatinine were related to a greater chance of SG, at multivariate analysis. An increase of proteinuria reduced this chance. Nephrotic syndrome was more common among the PG, while urinary abnormalities and nephritic syndrome prevailed in patients with SG., Conclusion: This is the first registry of glomerulopathies in Northeastern Brazil. It also presents a comparative analysis of the main clinical laboratory abnormalities of PG and SG, and includes the current classifications of glomerular diseases.

Beta-tricalcium phosphate (β-TCP) is one of the most widely employed bioresorbable materials for bone repair since it shows excellent biological compatibility, osteoconductivity and resorbability. The incorporation of divalent cations such as magnesium onto the β-TCP structure (β-TCMP) may improve the biological response to the material through the release of bioactive ions. The objective of this study was to evaluate, on a rat calvarial critical size grafting model, the bone regeneration process using β-TCP and β-TMCP granules by histomorphometric analysis. Results demonstrated that six months after bone grafting, the association of GBR (guided bone regeneration) using a membrane (GenDerm®) and granules of β-TCP and β-TCMP significantly improves bone repair in the treatment of critical-size defect in rat skulls, in comparison to untreated defects or GBR alone, leading to a bone level approximately four to five-fold greater than in the blood clot group. The β-TCMP+GenDerm® membrane group presented 40.5% of the defect area filled by newly-formed bone, even at the central part of the defect, rather than only at the border, as seen in the other experimental groups., (Copyright © 2015 Elsevier B.V. All rights reserved.)

This study evaluated the spatial and temporal distribution and density of the bivalve Donax striatus, at beaches close to the Apodi/Mossoró River estuary, through, six semiannual sampling campaigns were performed between April/2009 and October/2011. The sampled area was delimited by 20 transects that were laid perpendicular to the beach line and extended over 300 m in the intertidal zone. Seven sampling points were established in each transect, organisms and sediment were collected, and water temperature and salinity were recorded. The highest D. striatus average density (103 individuals.m-2) was observed in April/2009 and the lowest (18 individuals.m-2) in October/2010. The highest D. striatus densities occurred in beaches further from the estuarine region as demonstrated by a significant positive correlation (r2 = 0.67 and p = 0.0007). The D. striatus densities presented significant negative correlations with the percentages of organic matter in the water. This species demonstrated an aggregated distribution in the studied area.

Wollastonite-poly(n-butyl-2-cyanoacrylate) composite (W-BCA) has been proposed to immobilize anatomically bone fragments in order to achieve an optimal healing process. The present study evaluated the in vitro and in vivo behavior of three types of fillers: powdered natural wollastonite (Wn), synthetic pseudowollastonite powder (Ws), and synthetic pseudowollastonite powder coated with 5% acetyl tributyl citrate (Wst). The Wst-BCA composite underwent a higher degradability in the real-time degradation test and a superior cytotoxic effect; whereas the Wn-BCA composite showed a higher degradability in the accelerated test with no cytotoxicity. The formation of an extracellular collagenous matrix deposit on its surface and the most favorable new bone formation on Wn-BCA indicate its potential for bone adhesive use in unstable orthopedic traumas., (© 2013 Wiley Periodicals, Inc.)

Reactive oxygen species (ROS) modulate a variety of intracellular events, but their role in osteoblast adhesion and spreading remains unclear. ROS is a very-known physiological modulators of Protein Tyrosine Phosphatases activities, mainly to low molecular weight protein tyrosine phosphatase (LMW-PTP) activity. As this biological mechanism is not clear in osteoblast adhesion, we decided to investigate ROS levels and phosphorylations of FAK and Src, identifying these proteins as potential substrates to LMW-PTP activity. Our results showed that during osteoblast adhesion/spreading (30 min and 2 h of seeding) the intracellular ROS content (hydrogen peroxide) is finely regulated by an effective anti-oxidant system [catalase and Superoxide Dismutase (SOD) activities were evaluated]. During the first 30 min of adhesion, there was an increase in ROS production and a concomitant increase in focal adhesion kinase (FAK) activity after its phosphorylation at Tyrosine 397 (Y397 ). Moreover, after 2 h there was a decrease in ROS content and FAK phosphorylation. There was no significant change in LMW-PTP expression at 30 min or 2 h. In order to validate our hypothesis that LMW-PTP is able to control FAK activity by modulating its phosphorylation status, we decided to overexpress and silence LMW-PTP in this context. Our results showed that FAK phosphorylation at Y397 was increased and decreased in osteoblasts with silenced or overexpressed LMW-PTP, respectively. Together, these data show that ROS modulate FAK phosphorylation by an indirect way, suggesting that a LMW-PTP/FAK supra-molecular complex is involved in transient responses during osteoblast adhesion and spreading., (© 2013 Wiley Periodicals, Inc.)

This study investigates the long-term biocompatibility of 0.5 % zinc-containing hydroxyapatite compared with hydroxyapatite. Spheres (425 < ∅ < 550) of both materials were produced by extrusion of ceramic slurry in calcium chloride and characterized by FTIR, XRD, XRF and SEM. Fifteen White New Zealand rabbits were submitted to general anesthesia, and an perforation (2 mm), was made in each tibia, one for zinc-containing hydroxyapatite sphere implantation and one for hydroxyapatite sphere implantation. After 26, 52 and 78 weeks, the animals were euthanized, and the fragment containing the biomaterial was harvested. A 30-50 μm section was obtained for histological analysis in bright field and polarized light. SEM images revealed similar morphologies between the tested biomaterials. Histological analysis showed that there was no difference between the test groups. The morphometric analysis, however, indicates that there was a greater absorption. The materials are biocompatible, promote osteogenesis and that the zinc-containing hydroxyapatite microspheres were absorbed more quickly.

Purpose: To verify the effects of tibolone administration on trabecular and cortical bone of ovariectomized female rats by computed radiography system (CRS)., Methods: The experiment was performed on two groups of rats previously ovariectomized, one received tibolone (OVX+T) while the other did not (OVX), those groups were compared to a control group (C) not ovariectomized. Tibolone administration (1mg/day) began thirty days after the ovariectomy and the treatment remained for five months. At last, the animals were euthanized and femurs and tibias collected. Computed radiographies of the bones were obtained and the digital images were used to determine the bone optical density and cortical thickness on every group. All results were statistically evaluated with significance set at P<0.05%., Results: Tibolone administration was shown to be beneficial only in the densitometric analysis of the femoral head, performing higher optical density compared to OVX. No difference was found in cortical bone thickness., Conclusion: Ovariectomy caused bone loss in the analyzed regions and tibolone administered in high doses over a long period showed not to be fully beneficial, but preserved bone mass in the femoral head.

It is known that current trends on bone bioengineering seek ideal scaffolds and explore innovative methods to restore tissue function. In this way, the objective of this study was to evaluate the behavior of anorganic bovine bone as osteoblast carrier in critical-size calvarial defects. MC3T3-E1 osteoblast cells (1x10(5) cells/well) were cultured on granules of anorganic bovine bone in 24-well plates and after 24 h these granules were implanted into rat critical-size calvarial defects (group Biomaterial + Cells). In addition, other groups were established with different fillings of the defect: Blood Clot (negative control); Autogenous Bone (positive control); Biomaterial (only granules) and Cells (only MC3T3-E1 cells). After 30 days, the animals were euthanized and the calvaria were technically processed in order to allow histological and morphometric analysis. It was possible to detect blood vessels, connective tissue and newly formed bone in all groups. Particularly in the Biomaterial + Cells group, it was possible to observe a profile of biological events between the positive control group (autogenous bone) and the group in which only anorganic bovine granules were implanted. Altogether, the results of the present study showed that granules of anorganic bovine bone can be used as carrier to osteoblasts and that adding growth factors at the moment of implantation should maximize these results.

Introduction: Erectile dysfunction (ED) is highly prevalent among men undergoing hemodialysis., Aim: This study was performed to identify the influence of ED on the patient's quality of life (QoL) and to evaluate the influence of depression on erectile function of these patients., Main Outcome Measures: For this multicenter cross-sectional study, 275 patients were interviewed through questionnaires: the five-item version of the International Index of Erectile Function was used for diagnosing and classifying ED; the Medical Outcomes Study Questionnaire 36-Item Short Form Health Survey (SF-36) for scoring QoL; and the Hospital Anxiety and Depression Scale (HADS) to evaluate depressive symptoms. Linear regression was used to examine the associations between some of the variables and ED. Predialytic biochemical and hematological parameters were determined during the longer interdialytic period., Results: Patients had a mean age of 48.6 ± 12.8 years, and the ED prevalence was 72.3%. Advanced age, diabetes and depression score were independent risk factors for the development of ED as confirmed by linear regression (P < 0.001, P = 0.002, and P < 0.001, respectively). QoL was worse among patients with any degree of ED, and the scores were statistically significant for overall health rating (P = 0.016), physical composite score (P = 0.003), bodily pain (P = 0.042), physical functioning (P < 0.001), and vitality (P = 0.005). Furthermore, more severe forms of ED were associated with a lower QoL. After adjustment for some variables, such as age, time under dialysis, hemoglobin, albumin, parathyroid hormone, Kt/V, and depression, linear regression showed that domains related to poorer physical functioning (P = 0.047) and decreased vitality (P = 0.009) were significantly related to ED., Conclusion: Depression is an important trigger for the development of ED in hemodialysis patients, and this sexual condition is an independent risk factor for their poor QoL., (© 2010 International Society for Sexual Medicine.)