Objective To analyze the difference between turbine tooth separation method and turbine bone abrasion method for removal of mesioangular impacted mandibular third molar, providing reference for clinical preoperative design. Methods A total of 82 teeth from 68 outpatients were randomly divided into two groups, one group was treated by tooth separation method, the other group by bone abrasion method 41 teeth in each group. Tooth separation method group underwent turbine tooth separation; and the other group underwent turbine bone abrasion. Operation time, postoperative pain, swelling in the face and limitation of mouth opening degree were compared between the two groups. Results Compared with bone abrasion group (16.5±3.3) min, the operation time in tooth separation group(23.5±6.4)min was longer significantly (P<0.01). The postoperative pain in tooth separation group was lighter than in bone abrasion group, with significant difference (P<0.01). The swelling after operation in tooth separation group was lighter than in bone abrasion group, with significant difference (P<0.01). For limitation of mouth opening degree, both groups had no significant difference. Conclusions Using the turbine tooth separation method for extraction of impacted mandibular third molar can significantly reduce postoperative pain and swelling, but the operation time is longer than in the turbine bone abrasion method.