〔Abstract〕 Objective To investigate the effect of minimally invasive tooth extraction combined with gingival plasty on periodontal tissue injury and complications in patients with aesthetic denture repair. Methods A total of 88 patients who underwent aesthetic denture repair in Seth Stomatological Hospital of Henan University from August 2017 to January 2019 were randomly divided into a control group and an observation group according to random number table method, with 44 cases in each group. The control group received routine tooth extraction, and the observation group received minimally invasive tooth extraction combined with gingival formation. The effect of the patients was evaluated 7 days after surgery, and the 12 months outpatient followup was completed. The situation of alveolar process, complications, aesthetic effect and inflammatory factor levels of the two groups were compared. Results After treatment, the alveolar process morphology of the observation group was significantly better than that of the control group, the difference was statistically significant (Z = 5.191, P < 0.05). After treatment, the total incidence of infection, articulation disorder and non-scallop-like gingival margin in the observation group was 9.09 % which was lower than 43.18 % in the control group, and the difference was statistically significant (P < 0.05). After 1, 3, 6 and 12 months of repair, the pink esthetic scores (PES) of the two groups were significantly improved compared with before repair, and the PES scores of the observation group was higher than that of the control group, the differences were statistically significant (P < 0.05). After 7 days of repair, the levels of tumor necrosis factor (TNF-α) and C-reactive protein (CRP) in the two groups were lower than those before repair, and the levels of TNF-α and CRP of the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). Conclusion Compared with conventional extraction, minimally invasive extraction combined with gingival plasty can reduce the damage to periodontal tissue, reduce the incidence of complications and the level of inflammatory factors, and achieve better aesthetic effects.