Objective To explore the effect of Er:YAG laser combined with periodontal orthodontics on inffammatory factor levels in gingival crevicular ffuid of patients with aggressive periodontitis (AgP). Methods A total of 100 patients with AgP admitted to Suzhou Stomatological Hospital from January 2023 to July 2024 were selected, and they were divided into the control group and the study group by the random number table method, with 50 patients in each group. The control group was treated with periodontal orthodontics, and the study group was treated with Er:YAG laser combined with periodontal orthodontics. The inffammatory factor levels in gingival crevicular fluid, periodontal health indicators and facial aesthetics were compared between the two groups. Results After treatment, the levels of CRP, TNF-α, IL-4 and IL-6 in the study group were lower than those in the control group (P<0.05). After treatment, the GI, PLI, PD and CAL of the study group were better than those of the control group (P<0.05). After treatment, the alveolar bone defect height, periodontal pocket depth and anterior overjet of the study group were lower than those of the control group (P<0.05). Conclusion The combined application of Er:YAG laser and periodontal orthodontics in patients with AgP can reduce the levels of inffammatory factors in gingival crevicular ffuid, improve periodontal indicators and further optimize facial aesthetics.