Morphological Features of Complications from Purulent Necrotic Processes in the Maxillofacial Region Arising on the Background of Polyangiitis, Post-COVID Conditions, and Chronic Kidney Failure

maxillofacial necrosis; purulent-necrotic infection; polyangiitis; post-COVID syndrome; chronic kidney disease; histopathology; digital pathology; precision medicine.

Kurbonov Yoqubjon Khamdamovich
PhD, Associate Professor. Tashkent State
Medical University, Department of Dentistry
and Maxillofacial Surgery,
E-mail:[email protected]
https://orcid.org/0009-0009-6395-9220

Allazov Salakh Allazovich
Doctor of Medical Sciences, Professor of the
Department of Urology, Samarkand State
Medical University, Samarkand, Uzbekistan,
e-mail: [email protected];
ORCID:0009-0004-3449-2143

Received-18-06-2026
Revised-27-07-2026
Accepted-09-08-2026

European Journal of Prosthodontics and Restorative Dentistry (2026) 34(7s), 1382–1399

Morphological Features of Complications from PurulentNecrotic Processes in the Maxillofacial Region Arising on the Background of Polyangiitis, Post-COVID Conditions, and Chronic Kidney Failure

Purulent-necrotic processes of the maxillofacial region remain among the most severe complications in oral and maxillofacial surgery because they are frequently associated with extensive tissue destruction, prolonged hospitalization, and increased mortality. The clinical course becomes considerably more aggressive in patients with systemic disorders such as polyangiitis, post-COVID conditions, and chronic kidney failure, all of which are characterized by immune dysregulation, endothelial injury, microvascular thrombosis, and impaired tissue regeneration. Despite increasing recognition of these comorbidities, the combined morphological mechanisms responsible for the progression of maxillofacial necrosis have not been comprehensively characterized. This study aimed to investigate the morphological features of purulent-necrotic complications in the maxillofacial region associated with polyangiitis, post-COVID conditions, and chronic kidney failure and to develop an integrated morphological diagnostic framework for precision pathology. A comparative observational study was conducted using surgical tissue specimens obtained from patients with purulent-necrotic maxillofacial lesions and healthy control tissues. Histopathological examination, hematoxylin-eosin staining, Masson's trichrome staining, immunohistochemical evaluation of endothelial and inflammatory biomarkers, and digital morphometric analysis were performed to assess vascular injury, inflammatory infiltration, fibrosis, osteonecrosis, endothelial dysfunction, and tissue remodeling. The findings demonstrated pronounced endothelial damage, diffuse inflammatory cell infiltration, extensive microvascular thrombosis, progressive bone necrosis, increased fibrotic remodeling, and impaired angiogenesis in patients with systemic comorbidities. Digital morphometric assessment revealed significantly greater structural tissue destruction and vascular abnormalities in comparison with conventional histopathological evaluation. Based on these observations, an original Integrated Morphological Maxillofacial Necrosis Assessment Framework (IMMNAF) was developed by combining histopathological, immunohistochemical, vascular, inflammatory, and digital pathological parameters into a unified precision diagnostic model. This framework provides a comprehensive approach for individualized pathological assessment, improves diagnostic accuracy, facilitates early identification of high-risk patients, and supports personalized therapeutic planning for complex maxillofacial infections associated with systemic diseases. The proposed model may contribute to the advancement of precision pathology and optimize multidisciplinary management strategies in oral and maxillofacial surgery. •••••••••••••••••••••••••••••••• ejprd.org - Published by Riset Publication Services LLC

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