Objective To explore the effect of iRoot BP Plus in pulp preservation treatment of young permanent teeth and its influence on occlusal function and aesthetics. Methods A total of 70 patients who received pulp preservation treatment of young permanent teeth in our hospital from December 2018 to June 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 35 patients in each group. The control group was treated with mineral trioxide aggregate material for pulp preservation treatment, and the observation group was treated with iRoot BP Plus material for pulp preservation treatment. The clinical efficacy, occlusal function, adverse reactions and tooth aesthetics were compared between the two groups. Results There was no significant difference in the total effective rate between the two groups (P >0.05). There was no significant difference in the scores of language function and masticatory function between the two groups (P >0.05). After treatment, the scores of fixation function and comfort in the observation group were higher than those in the control group, and the differences were statistically significant (P <0.05). The incidence of adverse reactions in the observation group was 5.71%, which was lower than 22.86% in the control group, and the difference was statistically significant (P <0.05). After treatment, the score of tooth aesthetics in the observation group was higher than that in the control group, and the differences were statistically significant (P <0.05). Conclusion The application of iRoot BP Plus in the treatment of vital pulp preservation of young permanent teeth is effective, which can effectively improve the occlusal function of patients, improve the aesthetics of their teeth, and help reduce the risk of adverse reactions. It is worthy of clinical application.