Objective To explore the effect of different surface treatment methods on the long-term aesthetic effect and marginal adaptation of anterior resin restorations. Methods A total of 100 patients who underwent anterior resin restoration in Guilin Stomatological Hospital from January 2023 to December 2024 were selected, and they were divided into group A and group B by the random number table method, with 50 patients in each group. Group A was treated with simple polishing, and group B was treated with polishing combined with surface sealant. The marginal adaptation, White Esthetic Score (WES), color matching degree (ΔE value), surface roughness and satisfaction were compared between the two groups. Results The grade A rates of marginal adaptation in group B at 6 and 12 months after restoration (94.00%, 90.00%) were higher than those in group A (78.00%, 70.00%) (P<0.05). The total WES scores in group B at 6 and 12 months after restoration were higher than those in group A, and both ΔE and Ra values were lower than those in group A (P<0.05). The satisfaction score in group B at 12 months after restoration was (13.36±0.66)points, which was higher than (9.72±0.54)points in group A (P<0.05). Conclusion For anterior resin restoration, polishing combined with surface sealant treatment can more effectively maintain the marginal adaptation of restorations, improve aesthetic effect, inhibit the increase in surface roughness, and enhance patient satisfaction.