To explore the treatment effect of modified crown lengthening and orthodontic traction plus crown lengthening in gingival defect of upper anterior teeth. Methods A total of 82 patients with anterior gingival defect admitted to our hospital from May 2018 to May 2023 were selected as the research objects. According to different treatment schemes, they were divided into control group and study group, with 41 patients in each group. The control group was treated with modified crown lengthening, and the study group was treated with orthodontic traction and crown lengthening. The repair effect, periodontal health index, crown height change, complications and aesthetic effect satisfaction were compared between the two groups. results of the study group were compared with the control group. Results The excellent and good rate of repair in the study group was 95.12%, which was higher than 78.05% in the control group (P <0.05). The probing depth, gingival index, gingival sulcus bleeding index, plaque index and tooth mobility of the two groups at 12 weeks after operation were better than those before operation (P <0.05), but there was no significant difference between the study group and the control group (P >0.05). The changes of crown height in the two groups at 12 weeks after operation were higher than those at 2 weeks after operation (P <0.05), but there was no significant difference between the study group and the control group (P >0.05). The incidence of complications in the study group was slightly lower than that in the control group, but the difference was not statistically significant (P >0.05). The aesthetic effect satisfaction of the study group was higher than that of the control group (P <0.05). Conclusion Both modified crown lengthening and orthodontic traction plus crown lengthening can effectively improve periodontal health and crown height, and have high safety. However,orthodontic traction plus crown lengthening has better repair effect and aesthetic effect, and has higher application value in the treatment of upper anterior gingival defect.