Objective To explore the application effect of fixed denture and removable denture in the restoration of patients with periodontal disease complicated by dentition defect. Methods A total of 98 patients with periodontal disease complicated by dentition defect admitted to the Sixth People’s Hospital of Nantong from September 2022 to August 2025 were selected as the research subjects, and they were divided into the removable group (n=49) and the ffxed group (n=49) according to different treatment methods. The removable group received removable denture restoration, and the ffxed group received ffxed denture restoration. The periodontal health indicators, speech and masticatory function, quality of life and aesthetic effect were compared between the two groups. Results At 3 months after treatment, the PD, CAL and BI in the ffxed group were higher than those in the removable group (P<0.05). At 3 months after treatment, the scores of speech function and masticatory function in the ffxed group were higher than those in the removable group (P<0.05). At 3 months after treatment, the OHIP-14 score in the ffxed group was lower than that in the removable group (P<0.05). At 3 months after treatment, the WES score in the ffxed group was higher than that in the removable group (P<0.05). Conclusion In the restoration of patients with periodontal disease complicated by dentition defect, although ffxed denture is less effective in improving periodontal health than removable dentures, it can effectively enhance dental aesthetics, and improve speech and masticatory function, thus increasing patients’ quality of life.