Objective To analyze the improving effect of composite resin aesthetic restoration on facial aesthetics in patients with cervical wedge-shaped defect. Methods A total of 90 patients with cervical wedge-shaped defects treated at the Third People's Hospital of Shizuishan from January 2023 to January 2025 were selected and divided into the control group and the observation group by the random number table method, with 45 patients in each group. The control group received conventional resin fflling, and the observation group received composite resin aesthetic restoration. The restoration aesthetic effect, color matching degree (ΔE value) and satisfaction with facial appearance were compared between the two groups. Results The excellent and good rate of restoration aesthetics in the observation group at 6 months after treatment was 84.44%, which was higher than 55.56% in the control group (P<0.05). There was no statistically signiffcant difference in immediate postoperative ΔE value of restoration color matching between the two groups (P>0.05). The ΔE values of the observation group at 1 month and 6 months after operation were lower than those of the control group (P<0.05). The satisfaction rate with facial appearance in the observation group (91.11%) was higher than that of the control group (71.11%) (P<0.05). Conclusion Composite resin aesthetic restoration can optimize the aesthetic effect of restorations for cervical wedge-shaped defect, effectively enhance long-term color matching and improve satisfaction with facial aesthetics, which is worthy of clinical promotion.