Abstract: Objective: To investigate the effects of two pathways of lingual plates in the extraction of low impacted mandibular third molars on postoperative tissue reaction. Methods: 136 patients undergoing low impacted mandibular third molar were randomly divided into bone plate resection group (n=67) and bone plate splitting surgery group (n=69). Lingual plate resection and lingual plate splitting surgery were performed for teeth extraction, respectively. The operating time, postoperative pain and facial swelling occurrence of the two groups were recorded. At 48h and 7d after surgery, the degrees of mouth opening and odynophagia of the two groups were compared. Results: After surgery, all patients reached healing. The operation time in bone plate splitting surgery group was shorter than the bone plate resection group, and facial swelling was less than the bone plate resection group (P<0.05). At 48h and 7d after surgery, the degrees of mouth opening in the two groups were reduced (P<0.05). At 48h after surgery, the degree of mouth opening in bone plate splitting surgery group was greater than the bone plate resection group, and meanwhile the occurrence of odynophagia was less (P<0.05). At 7d after surgery, the differences in the degree of mouth opening and odynophagia between the two groups were not significant. Conclusion: Compared with lingual plate resection, lingual plate splitting surgery used in the extraction of low impacted mandibular third molars could effectively reduce the operation time and the occurrence of facial swelling, accompanied by less postoperative tissue reaction.