Objective To analyze the effect of orthodontics combined with porcelain bridge fixed restoration on masticatory function and aesthetics in adult patients with malocclusion. Methods A total of 60 adult patients with malocclusion admitted to the Department of Stomatology of our hospital from March 2023 to March 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group received porcelain bridge ffxed restoration, and the observation group received orthodontics combined with porcelain bridge ffxed restoration. The orthodontic effect, masticatory function, aesthetics, treatment satisfaction and complication rate were compared between the two groups. Results The total effective rate of treatment in the observation group was higher than that in the control group (P<0.05). The scores of masticatory function and aesthetics in the observation group after treatment were higher than those in the control group (P<0.05). The treatment satisfaction rate of the observation group (93.33%) was higher than that of the control group (73.33%) (P<0.05). The incidence of complications in the observation group (3.33%) was lower than that in the control group (20.00%) (P<0.05). Conclusion Orthodontics combined with porcelain bridge ffxed restoration has deffnite efffcacy in adult patients with malocclusion. It can improve orthodontic effect, enhance masticatory function and aesthetics, increase treatment satisfaction and reduce the incidence of complications, which is worthy of clinical application.