To compare the clinical efficacy of metal post and prefabricated fiber post for oral restoration. Methods A total of 80 patients who underwent oral repair in our hospital from August 2022 to August 2023 were selected as the research objects and divided into control group and observation group according to the random number table method, with 40 patients in each group. The control group was treated with metal post for oral restoration, and the observation group was treated with prefabricated fiber post for oral restoration. The clinical efficacy, repair time, repair success rate, periodontal index, complication rate and satisfaction were compared between the two groups. Results The total effective rate of repair in the observation group was 95.00%, which was higher than 75.00% in the control group (P <0.05). The repair time of the observation group was shorter than that of the control group, and the success rate of repair was higher than that of the control group (P <0.05). The tooth mobility, BI, PLI and PD in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group was 2.50%, which was lower than 17.50% in the control group (P <0.05). The satisfaction rate of the observation group was 95.00%, which was higher than 75.00% of the control group (P <0.05). Conclusion Compared with metal post for oral restoration, the clinical efficacy of prefabricated fiber post is more ideal. Its repair time is shorter, the success rate of repair is higher, and the incidence of complications is lower. Meanwhile, it can effectively improve the patient's periodontal index and improve patient satisfaction, which is worthy of clinical application.