Objective To analyze the effect of minimally invasive tooth extraction with ultrasonic bone scalpel on inffammatory factor levels and mouth opening limitation in patients undergoing extraction of mandibular impacted wisdom teeth. Methods A total of 50 patients with mandibular impacted wisdom teeth admitted to the Department of Stomatology, Nantong Hospital of Traditional Chinese Medicine from January 2020 to June 2023 were selected. According to the random number table method, they were divided into the traditional group and the minimally invasive group, with 25 patients in each group. The traditional group received conventional tooth extraction, and the minimally invasive group received minimally invasive tooth extraction with ultrasonic bone scalpel. The inffammatory factor levels, mouth opening limitation, recovery effect and complications were compared between the two groups. Results After surgery, the levels of IL-6 and IL-1β in the minimally invasive group were lower than those in the traditional group (P<0.05). The proportion of patients with grade 0 mouth opening limitation in the minimally invasive group was 44.00%, which was higher than 12.00% in the traditional group (P<0.05). After surgery, the wound swelling degree and VAS score in the minimally invasive group were lower than those in the traditional group (P<0.05). The incidence of complications in the minimally invasive group (4.00%) was lower than that in the traditional group (24.00%) (P<0.05). Conclusion Minimally invasive tooth extraction with ultrasonic bone scalpel induces milder inffammatory response in patients with mandibular impacted wisdom teeth. It can effectively improve postoperative mouth opening limitation, alleviate postoperative swelling and pain, and has high safety.