To explore the effect of orthodontic combined with porcelain cosmetic on patients' aesthetics and satisfaction. Methods Sixty patients with tooth defects admitted to our hospital from January to December 2022 were selected and divided into control group and observation group according to the random number table method, with 30 patients in each group. The control group received post-core orthodontic restoration, and the observation group received post-core orthodontic combined with porcelain cosmetic restoration. The clinical efficacy, aesthetic repair effect, periodontal status and complications were compared between the two groups. Results The total effective rate of the observation group was 96.67%, which was higher than 76.67% of the control group (P <0.05). The color, shape, translucency and edge aesthetics of the teeth in the observation group were higher than those in the control group after restoration (P <0.05). The scores of PD, BI, AL and PLI in the observation group were lower than those in the control group af ter restoration (P <0.05). The incidence of complications in the observation group was 0, which was lower than 16.67 % in the control group (P <0.05). Conclusion Orthodontic combined with porcelain cosmetic can achieve satisfactory results for patients with tooth defects, improve the aesthetic measure of teeth, improve the periodontal status, and reduce the incidence of complications.