According to the health statistics of China in 2006, the mortality rate of tumor has surpassed that of cardiovascular and cerebrovascular diseases, taking the first place. Oral and maxillofacial – head and neck tumors account for about 7-10% of the whole body tumors. The level of diagnosis and treatment advances with the development of medicine and biology. In terms of diagnosis and prognosis, research on tumor biomarkers is in full swing. Since the 21st century, exploring the specific genes of different tumors at the molecular level has become a major hot spot, and the main and commonly used method is gene microarray screening. Preliminary studies have found that several genes are related to the development, metastasis and prognosis of head and neck squamous carcinoma, but so far, no highly specific oral and maxillofacial tumor markers have been found. With the increasing understanding of the disease, some diseases have standardized names, such as: NK-T cell lymphoma: lethal midline granuloma, malignant granuloma, pleomorphic reticulocytosis, angiogenic central lymphoma. langhans celldisease: histiocytosis X. odontogenic keratocysticercosis: odontogenic keratocysticercosis. In terms of treatment, there is an increasing emphasis on comprehensive treatment and measures to prevent recurrence and metastasis. Radical resection and reconstructive surgery are given equal importance, and overall consideration is given to improving survival rates and quality of life, emphasizing that the tumor is firstly excised; then the functions of mastication, swallowing, speech and respiration are restored; and finally, consideration is given to restoring the appearance of appearance as much as possible. In this century, the advancement and clinical application of dental implant technology, especially the application of three-dimensional rapid prototype technology and simulated restoration technology, has enabled the restoration of oral and maxillofacial defects to achieve the purpose of “individualized” treatment, which has rapidly improved the restoration effect. Since the concept of minimally invasive surgery was introduced in the 1980s, minimally invasive surgery for head and neck tumors has also developed rapidly, and the effectiveness of decompression window drainage negative pressure suction for odontogenic keratotic cysts and cystic enamel cell tumors has been confirmed. Minimally invasive surgery such as interventional treatment of intra-maxillary vascular malformation and endoscopic-assisted resection of superficial parotid lobe tumors is gaining attention. Comprehensive sequential treatment for patients with advanced tumors, as well as limited malignant lymphoma and Langerhans cell disease, which often occur in the head and neck, are indications for non-surgical treatment. Radiotherapy, chemotherapy, thermotherapy and Chinese herbal medicine are the main treatments for those who are inoperable in late stages. Biological therapy has also been gradually developed in recent years. There are many histological types of oral and maxillofacial tumors, and the common malignant tumors are squamous cell carcinoma, mucous epidermis-like carcinoma, adenoid cystic carcinoma, and basal cell carcinoma. Squamous cell carcinoma constitutes the bulk of oral, hypopharyngeal and cervical esophageal cancers. Squamous cell carcinoma: Squamous cell carcinoma constitutes the majority of oral cancer, hypopharyngeal cancer and cervical esophageal cancer. Among oral cancers, the most common site in China is the tongue, followed by the cheek, gums, hard palate, and floor of the mouth. The overall five-year survival rate is 31%-66%. Among oropharyngeal cancers, tonsillar crypt is the most common site, followed by soft palate, tongue root, lateral wall of pharynx and posterior wall of pharynx, and the overall five-year survival rate is 17%-57%. The occurrence of oral cancer is closely related to tobacco and alcohol habits. In addition, ultraviolet light is related to the occurrence of lip cancer and skin cancer of the head and neck. Chronic inflammatory stimulation and injury in the oral cavity, such as root and crown remnants, can stimulate and damage the buccal mucosa and lead to the occurrence of buccal cancer. Pre-cancerous lesions such as leukoplakia, oral submucosal fibrosis, lichen planus and other malignant changes, as well as micro-currents generated by two different metal dental filling materials in the mouth, can lead to oral cancer. Oral cancer is located on the surface of the body and should be detected at an early stage. However, due to the lack of popular education, regular oral examination and professional talents in oral cancer prevention, a considerable number of patients are already in the middle and late stages when they are diagnosed with oral cancer. Some patients have been diagnosed and treated with “oral ulcers” for half a year until the tumor that breaks down is obvious. Clinically, if an ulcer is found to be more than one month old, especially if the ulcer is hard, a biopsy should be performed in time. Special attention should be paid to differentiate these ulcers from traumatic ulcers, tuberculous ulcers and necrotizing periglandular sores, which are usually soft in texture. Basal cell carcinoma: Basal cell carcinoma often occurs in the head and neck, and more often in the middle of the face, up to 50-60%. At the beginning of the lesion, there is no conscious symptom and the growth is generally slow. At the beginning, the lesion resembles pearl-like hard nodules, which can be brownish in color, flaking and crusting in the middle, sometimes forming ulcers and developing aggressively in all directions, destroying surrounding tissues and organs including bone tissue. Pathologically, basal cell carcinoma is divided into superficial, solid, pigmented, fibrotic, cystic, adenoid, and keratinized types. Most basal cell carcinomas do not metastasize to lymph nodes, and the prognosis is generally good. Melanoma: Malignant melanoma is often the result of a change in pigmented nevus. Sudden pigmentation of pigmented nevus recently, even itching and stinging, rupture and oozing of blood and fluid, redness around the pigment, pseudopod extending to the surrounding area, and enlarged regional lymph nodes suggest malignant transformation. Malignant melanoma of head and neck accounts for about 20% of the malignant melanoma of the whole body. Cutaneous malignant melanoma is divided into superficial extension type, nodular type, malignant freckle type and limb freckle type. Superficial extension type is the main type, which mostly occurs on the basis of pigmented hemorrhoids. Mucosal malignant melanomas are more malignant than cutaneous ones. Most oral malignant melanomas occur on the basis of pigmented lesions, commonly on the palate, gums, cheeks and tongue. The tumors are brownish-black in color and may be associated with surface rupture, and often invade bone tissue and are prone to blood and lymphatic metastasis. The prognosis of squamous cell carcinoma and basal cell carcinoma of the skin, which occur in the area damaged by ultraviolet radiation, is generally good as long as the lesions are not large or do not invade bone tissues, and the prognosis of malignant melanoma that does not invade the muscle layer, which is also malignant from pigmented nevus, is also good. It is important to note that non-pigmented malignant melanoma is easily confused with squamous cell carcinoma, and the pseudoepithelioma-like growths overlying malignant melanoma are often misdiagnosed as invasive squamous cell carcinoma. Most squamous cell carcinomas and basal cell carcinomas have a fixed growth type, and only a few basal cell carcinomas have indeterminate growth characteristics with lymphatic and hematologic metastasis, so basal cell carcinomas with infiltrative growth should be followed and monitored for a long time after surgery. Some non-malignant tumors have very similar clinical manifestations and must be differentiated. Keratoacanthoma, which is often misdiagnosed as a malignant tumor, is common in men over 40 years of age and is often solitary and indistinguishable from skin cancer. The lesion mainly involves the exposed skin, such as the face and neck, scalp and other parts. It starts as a hard papule, but rapidly grows into a nodule, which is a pink elevation with a central depression resembling a crater, containing keratinous plugs, and capillary dilation is common on the surface. After 3-5 weeks, it can reach 1-3 cm and even 5-8 cm. The growth ceases to increase to a certain extent, and after 2-8 weeks of quiescence, the lesion gradually fades away, leaving an atrophic scar. The entire course of the disease from proliferation, quiescence to regression is about 2-8 months. Aging keratoacanthoma multiforme lesions are small, rarely exceeding 1.5 cm in diameter, often with severe itching, and without familial tendency. It is easily confused with highly differentiated squamous cell carcinoma, which has well differentiated cells, no interstitial changes, proliferation of central spiny cell layer, regular arrangement, clear demarcation with normal epithelium, no infiltration, and no metastasis. Basal cell carcinoma syndrome: Clinically, basal cell carcinoma syndrome has a clear familial tendency and is characterized by clinical manifestations such as multiple keratotic cysts of the jaws, basal cell nevi or basal cell carcinomas, etc. Multiple keratotic cysts of the jaws appear at a young age, while basal cell carcinomas usually appear one after another after the age of 50. skin, surface roughness and flaking, similar to the manifestation like senile dermatitis, pathologically confirmed as basal cell carcinoma, which has a good prognosis without infiltration and metastasis, although it occurs in many different sites and is surgically removed many times. Necrotizing peri-mucous glanditis Squamous cell carcinoma of oral mucosa, especially of palatal mucosa origin, needs to be excluded when ulceration is the main clinical manifestation. Although this lesion reaches the bone surface deeply and causes bone exposure, there is no bone destruction and the ulcerated surface does not exceed 2 cm in diameter and can heal spontaneously. Traumatic ulcers Oral ulcers caused by defective denture or residual root and crown are easily misdiagnosed as squamous cell carcinoma, especially when there is inflammatory edema in the surrounding tissues, but they are soft to touch without infiltrative hard mass. The common malignant tumors of glandular origin are mucinous epidermoid carcinoma and adenoid cystic carcinoma. The biological characteristics and treatment of mucinous epidermis-like carcinoma are basically the same as those of squamous carcinoma. Mucinous epidermis-like carcinoma of the palate must be differentiated from hemangioma. Adenoid cystic carcinoma is generally difficult to be removed due to its neurophilic nature and early occurrence of distant metastasis, and although it grows slowly, it is extremely invasive, and the application of radiation particles has good efficacy. The treatment methods of oral and maxillofacial malignant tumors still adopt surgery, radiotherapy, chemotherapy, thermotherapy, immunotherapy, laser, freezing and traditional Chinese medicine. Surgical resection of tumors and post-resection repair need to consider the tolerance of their heart, blood vessels, respiratory function and wound healing ability; the choice of anesthesia should also be cautious. Radiotherapy can aggravate oral dryness, oral mucous membrane rupture that does not heal easily, and swallowing difficulties. Radiotherapy for lung metastases is prone to radiation pneumonia and pulmonary fibrosis, which further damage lung function. The jaws are prone to radioactive osteomyelitis. Chemotherapy aggravates the liver and kidney insufficiency of patients, and the metabolism and excretion function of chemotherapy drugs are correspondingly weakened in those with liver and kidney insufficiency, so we should be more careful in choosing the variety, course and dose of chemotherapy drugs. In patients with heart disease, anthracyclines, such as adriamycin and erythromycin, should not be used or used sparingly. The first surgical excision is the key to cure. If the surgery is not clean, even though postoperative radiotherapy or/and chemotherapy can inhibit the growth of cancer cells, at this stage, the possibility of cure is almost non-existent. Therefore, pathological examination of routine intraoperative surgical margins should be strongly advocated to strive for a clean surgical excision. For T1 and T2 patients, postoperative radiotherapy or chemotherapy is not necessary for those with complete lesion resection. In addition, exploration of the anterior lymph nodes can help to determine the metastasis of lymph nodes. The concentration of isotope or dye in lymph nodes only indicates that the lymphatic return from the tumor site reaches the lymph node first, but does not indicate absolute metastasis, and is only a reference basis for the scope of cervical lymphatic clearance. Most basal cell carcinomas are sensitive to radiotherapy, but very few patients, especially solid type basal cell carcinomas, are insensitive to radiotherapy, and although the tumor is growing slowly, radiotherapy is difficult to control. For superficial and small lesions, freezing, laser and surgery can achieve better results. If the lesions are extensive, jaw bone involved or recurrent foci, then comprehensive radiotherapy and surgery should be adopted, and conservative treatment is not recommended. Malignant melanoma is treated with freezing, immunotherapy, chemotherapy and surgery. Progress in revision therapy: In the treatment of oral and maxillofacial skin and mucosa malignant tumors, reconstruction and revision of tissues and organs are often required to cover the trauma and restore the shape and function as much as possible. The commonly used repair flaps are: Chinese flap, i.e. forearm radial flap with vascular free graft; frontal flap, pectoralis major muscle flap, shoulder deltoid muscle flap, latissimus dorsi muscle flap, fibula composite flap, etc. These flaps are especially suitable for the treatment of oral and maxillofacial skin and mucosa malignancies. These flaps, especially the composite flap with vascular free graft, must be braked on the head and neck for 7-10 days due to the use of microsurgical techniques for vascular anastomosis, and the bedridden elderly are prone to joint stiffness of the limbs, slow venous return of the limbs and deep vein thrombosis, so it is necessary to strengthen the passive activities of the limbs. Minimally invasive surgery: decompression and opening drainage negative pressure suction for odontogenic keratotic cysts and cystic enamel cell tumors is effective. The application of robot in oral and maxillofacial tumors is similar to endoscopic surgery, which is less invasive and not difficult to operate. Interventional treatment of intra-maxillary vascular malformation, endoscopic-assisted resection of superficial parotid lobe tumors, etc. Comprehensive sequential treatment for patients with advanced tumors: malignant lymphoma and Langerhans cell disease, which often occur in the head and neck, are all indications for non-surgical treatment. For those who cannot be operated in late stage, radiotherapy, chemotherapy, thermotherapy and Chinese herbal medicine are adopted as the main treatments. Biological therapy has also been gradually developed in recent years. Many human tumor cells express EGFR on the surface, and inhibition of EGFR expression in tumor cells can inhibit tumor growth or progression. The significance of EGFR and TGFα expression on the prognosis of head and neck squamous carcinoma. EGFR expression is a poor prognostic indication, with short patient survival and high metastasis rate. Epidermal factor inhibitors: anti-EGFR monoclonal antibodies, nitrozumab (h-R3), cetuximab (C225); tyrosine kinase receptor inhibitors, gefitinib, erlotinib. Advances in radiotherapy: In external irradiation, intensity-modulated and conformal radiotherapy has been effective in maximizing the preservation of normal tissue and increasing the dose to the target area. Stereotactic radiotherapy uses an image-guided real-time tracking system to guide the robotic arm to drive the linear gas pedal to track the target area for treatment. It is reproducible, highly accurate, less invasive, and widely applicable, allowing for forward/reverse treatment planning and fractionated treatment, and is compatible with both radiosurgery and radiotherapy. In proton radiotherapy, the energy decay shows a Bragg peak. The normal tissue in front of the tumor receives about 1/3 of the dose, while the posterior part of the tumor is essentially unharmed. Head and neck cancer, especially nasopharyngeal cancer. Neutron radiotherapy, which is completely different from photons in terms of tissue action, can act directly on DNA, solving the problem of radiation resistance in hypoxic tumors. Salivary gland tumors are more sensitive, with significant improvement in local control rates and a slight improvement in survival rates. Carbon ion radiotherapy, with most of the energy distributed at the end of the trajectory, improves the biological effect of treatment within the ionization absorption peak, resulting in higher physical selectivity, improved dose distribution, concentrated dose within the target site, and reduced irradiation of normal tissues,” thus, heavily charged ion radiotherapy is valuable in the clinical management of radiotherapy insensitive and critical tumors. Otherwise, continuous high-dose radiotherapy will not control the development of the lesion, but will also cause postoperative necrosis of the jaws, resulting in non-healing trauma and difficulties in local repair. Inter-tissue radiotherapy with nuclear 125 I particles has high local control rate, low adverse effects, especially for adenogenic tumors, and can preserve the facial nerve. Postoperative chemotherapy should be started 2-3 weeks after surgery, when new blood vessels have just started to form at the surgical site, and the drugs can reach the local area through rich blood flow. After radiotherapy, local endovascular inflammation, narrowing of blood vessel lumen, and reduction of blood flow are less effective if chemotherapy is administered. At present, local chemotherapy of tumor is also gradually carried out, and the new anti-cancer concept of slow-release library is gaining success. With the use of slow-release technology and injection technology, the anti-cancer drugs are concentrated in the tumor area, and their half-life is tens of times longer than that of intravenous application, and they can kill cancer cells rapidly and permanently after being injected into the tumor tissue. Since the injected drug stays inside the tumor and does not participate in blood circulation, it has no obvious toxic side effects and protects normal tissues at the same time. Cisplatin microspheres, adriamycin microspheres and mitomycin microspheres for injection combine transarterial embolization and drug slow release, which also improve the efficacy and reduce the toxic side effects. In terms of basic research, new cell lines (strains) and tumor models and models are continuously established, such as human HPV16 E6/E7 immortalized oral epithelial cell line, immortalized enamel-forming cell tumor strain, human salivary gland tumor PLAG1 transgenic mouse model, transgenic hemangioma animal model, and SD rat buccal private membrane squamous carcinoma cell line. This has an important role in exploring the mechanism of carcinogenesis, biological characteristics of tumors and experimental prevention and treatment research work. In recent years, China has started to study the biological characteristics of stem cells in the occurrence and development of oral and maxillofacial tumors, infiltration and metastasis, such as the successful initial isolation of adenoid cystic carcinoma (ACC) stem cells.