Objective To analyze the clinical effect of orthodontics combined with repair treatment in adult malocclusion and its influence on tooth function and aesthetics. Methods A total of 56 adult patients with malocclusion admitted to our hospital from May 2023 to May 2024 were selected as the research objects. According to different treatment methods, they were divided into orthodontic group and combined group, with 28 patients in each group. The orthodontic group was treated with orthodontic treatment, and the combined group was treated with orthodontic treatment combined with repair treatment. The repair effect, tooth function, aesthetics, comfort, treatment satisfaction and quality of life were compared between the two groups. Results The total effective rate of repair in the combined group was 96.43%, which was higher than 89.29% in the orthodontic group (P <0.05). The dental function scores of the two groups after treatment were higher than those before treatment (P <0.05), but there was no significant difference between the two groups (P >0.05). The aesthetic score and comfort score of the two groups after treatment were higher than those before treatment (P <0.05), but there was no significant difference between the two groups (P >0.05). The treatment satisfaction of the combined group was 96.43%, which was higher than 89.29% of the orthodontic group (P <0.05). The quality of life scores of the two groups after treatment were higher than those before treatment, and the combined group was higher than the orthodontic group (P <0.05). Conclusion The clinical effect of orthodontics combined with repair treatment in adult malocclusion is more ideal, which can improve the language function and masticatory function, and improve patient satisfaction and quality of life. It is worthy of clinical application.