Objective To observe and compare the clinical effects of immediate implant restoration and residual root preservation restoration in the treatment of anterior structure defects. Methods A total of 56 patients who received anterior tooth structure defect restoration treatment in our hospital from June 2020 to September 2023 were selected as the research subjects and divided into the control group and the observation group using the random number table method, with 28 cases in group. The control group received residual root preservation restoration treatment, while the observation group received immediate implant restoration treatment. The oral function, chewing function, treatment satisfaction complication incidence, and pink esthetic score (PES) were compared between the two groups. Results After treatment, the scores of oral function (comfort, aesthetics speech function, retention) in both groups were higher than before treatment, and the observation group was higher than the control group (P<0.05). The of chewing pain, chewing speed, chewing stability, and chewing efficiency in the observation group were all higher than those in the control group (P<0.05). The satisfaction scores of overall aesthetics, attachment height, chewing function, and color appearance in the observation group were all higher than those in the control group (P<0.05). The complication incidence in the observation group (7.14%) was lower than that in the control group (17.86 (P<0.05). The PES scores in both groups were higher than before treatment, and the observation group was higher than the control group (P<0.05). Conclusion There are differences in the clinical effects of immediate implant restoration and residual root preservation restoration in the treatment of anterior tooth structure defects, the restoration effect of immediate implant restoration is more significant. It can improve chewing function and treatment satisfaction, reduce the incidence of complications, enhance oral function, and increase pink esthetic score. Therefore, it can be considered as the preferred restoration method.