Objective To investigate the effect of periodontal reconstructive surgery assisted oral restoration on patients with tooth defect and its effect on periodontal function and tooth aesthetics. Methods A total of 100 patients with tooth defect admitted to our hospital from January to December 2023 were selected as the research objects. According to the different treatment plans, they were divided into control group and observation group, with 50 patients in each group. The control group was treated with routine oral repair, and the observation group was treated with periodontal reconstructive surgery assisted oral restoration. The treatment effect, periodontal function, tooth aesthetics and patient satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 100.00%, which was higher than 94.00% in the control group, but the difference was not significant (P >0.05). After treatment, AL、PD、PLI、BOP in the observation group were better than those in the control group (P <0.05). The proportion of Class Ⅰ and Class Ⅱ in tooth aesthetics of the observation group was higher than that of the control group (P <0.05). The satisfaction of patients in the observation group was 98.00%, which was higher than 86.00% in the control group (P <0.05). Conclusion The treatment of periodontal reconstructive surgery assisted oral restoration for patients with tooth defect can improve their periodontal function and improve the aesthetics of teeth, and the patient's recognition is high.