Objective To explore the effect of modified coronal extraction method on pain in patients undergoing extraction of mandibular mesioangular impacted tooth in medium position. Methods A total of 80 patients who underwent extraction of mandibular mesioangular impacted tooth in medium position at Guiping People's Hospital from November 2023 to November 2024 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional extraction method, and the observation group received modified coronal extraction method. The pain status, compliance, anxiety status, complication rate and comfort level were compared between the two groups. Results The VAS score of the observation group at 3 days after operation was lower than that of the control group (P<0.05). The compliance score of the observation group was higher than that of the control group (P<0.05). The SAS scores of the observation group at 30 minutes and 3 days after operation were lower than those of the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). The GCQ score of the observation group was higher than that of the control group (P<0.05). Conclusion The application of modiffed coronal extraction method in the extraction of mandibular mesioangular impacted tooth in medium position can effectively reduce postoperative pain, improve treatment compliance, alleviate postoperative anxiety, reduce the incidence of complications, and thus enhance the overall comfort of patients.