Objective To explore the effect of hierarchical management mode in oral implant restoration nursing. Methods Sixty patients who underwent oral implantation in our hospital from January 2021 to December 2023 were selected as the research objects. They were divided into conventional group and experimental group by random number table method, with 30 patients in each group. The conventional group adopted the conventional management mode, and the experimental group adopted the hierarchical management mode. The quality of nursing service, periodontal health status, nursing satisfaction, adverse emotions and adverse reactions were compared between the two groups. Results The scores of ward management, operation technology, document writing, disinfection and isolation in the experimental group were higher than those in the conventional group (P <0.05). After intervention, GI, PD, BI and PLI in the experimental group were better than those in the conventional group (P <0.05). The nursing satisfaction of the experimental group was 96.67%, which was higher than 70.00% of the conventional group (P <0.05). After intervention, the SAS score and SDS score of the experimental group were lower than those of the conventional group (P <0.05). The incidence of adverse reactions in the experimental group was 6.67%, which was lower than 13.33% in the conventional group (P <0.05). Conclusion The application of hierarchical management mode in oral implant restoration nursing is effective, which can effectively improve the quality of nursing service, improve the periodontal health status of patients, and reduce the risk of adverse reactions. Meanwhile, it is conducive to reducing the adverse emotions of patients and improving their satisfaction.