Objective To explore the clinical effect of direct adhesive composite resin restoration technique in aesthetic restoration of anterior teeth and analyze its influence on patients' periodontal health indicators. Methods A total of 80 patients requiring aesthetic restoration of anterior teeth admitted to Yixing Stomatological Hospital from January 2023 to August 2024 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group was treated with traditional direct composite fflling, and the observation group was treated with direct adhesive composite resin restoration technique. The aesthetic restoration effect, satisfaction, periodontal health indicators and complications were compared between the two groups. Results The scores of color matching, marginal adaptation, tooth morphology, surface smoothness and VAS in the observation group were better than those in the control group (P<0.05). At 6 months after operation, the PLI, GI, SBI and PD of the observation group were better than those of the control group (P<0.05). The incidence of complications in the observation group (7.50%) was lower than that of the control group (25.00%) (P<0.05). Conclusion The application of direct adhesive composite resin restoration technique in aesthetic restoration of anterior teeth achieves favorable aesthetic effect. It can improve patients' periodontal microenvironment, and reduce the risk of periodontal inffammation, with high clinical safety.