Objective To investigate the effectiveness of periodontal reconstructive surgery before oral rehabilitation. Methods A total of 76 patients with oral rehabilitation admitted to our hospital from January 2020 to December 2022 were randomly divided into control group and observation group, with 38 patients in each group. The control group was given routine repair, and the observation group was given periodontal reconstruction surgery before oral rehabilitation. The oral function, excellent and good rate of recovery, incidence of adverse reactions, periodontal probing depth, periodontal attachment level and gingival atrophy rate were compared between the two groups. Results The scores of oral function in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05). The excellent and good rate of recovery in the observation group was higher than that in the control group, the difference was statistically significant (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P<0.05). After treatment, the periodontal probing depth and periodontal attachment level in the observation group were better than those in the control group, and the differences were statistically significant (P<0.05). The gingival atrophy rate of the observation group was lower than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Periodontal reconstruction surgery before oral rehabilitation is very important, which can effectively improve the oral function, improve the excellent and good rate of recovery, improve the depth of periodontal exploration, periodontal attachment level, and reduce the incidence of gingival atrophy.