Objective To explore the effect of bracketless invisible appliance on aesthetic effect and periodontal health of patients with Angle Class Ⅱ malocclusion. Methods A total of 76 patients with Angle Class Ⅱ malocclusion admitted to Wuzhou Traditional Chinese Medicine Hospital from July to December 2023 were selected as the research subjects, and they were divided into the reference group and the observation group by the random number table method, with 38 patients in each group. The reference group was treated with self-ligating bracket appliance, and the observation group was treated with bracketless invisible appliance. The aesthetic effect, periodontal health, occlusal function and adverse reaction rate were compared between the two groups. Results The aesthetic score of the observation group after treatment was higher than that of the reference group (P<0.05). The gingival index, plaque index, probing depth and papilla index of the observation group after treatment were lower than those of the reference group (P<0.05). The occlusal contact time of the observation group was shorter than that of the reference group, and the occlusal center position and occlusal force were better than those of the reference group (P<0.05). The incidence of adverse reactions in the observation group (2.63%) was lower than that in the reference group (18.42%) (P<0.05). Conclusion For patients with Angle Class Ⅱ malocclusion, the application of bracketless invisible appliance can not only effectively improve the periodontal health status and promote the recovery of occlusal function, but also have good aesthetic effect and low incidence of adverse reactions.