Objective To explore the effectiveness and feasibility of alveolar bone regeneration orthodontic treatment in adult patients with moderate to severe periodontitis with malocclusion deformity. Methods From May 2020 to June 2021, 30 adult patients with moderate to severe periodontitis with malocclusion deformity admitted to our hospital were included in the study. All patients were treated with alveolar bone regeneration orthodontic treatment. The clinical efficacy, pain (VAS score), inflammatory factor levels (IL-5, IL-6, IL-1β, TNF-α), gingival index (gingival index, gingival sulcus bleeding index, plaque index and attachment loss), alveolar bone density and bone defect height were observed before and after treatment. Results The total effective rate after treatment was as high as 96.67%. After treatment, the VAS score and the levels of IL-5, IL-6, IL-1β and TNF-α were lower than those before treatment (P<0.05). After treatment, the gingival index, gingival sulcus bleeding index, plaque index and attachment loss index were lower than those before treatment (P<0.05). After treatment, the alveolar bone density was higher than that before treatment, and the height of bone defect was lower than that before treatment (P<0.05). Conclusion Alveolar bone regeneration orthodontics has a good effect in the treatment of moderate to severe periodontitis with malocclusion deformity in adults. It has positive significance in improving the total effective rate of treatment, reducing the pain degree and inflammatory factor level of patients, and improving the gingival index, alveolar bone density and bone defect height of patients.