Objective To compare the effects of early soft tissue closure and delayed soft tissue closure on clinical healing indicators and aesthetic effect after secondary implant surgery. Methods A total of 100 patients with posterior tooth loss requiring implant restoration admitted to Fangchenggang Hospital of Traditional Chinese Medicine from January 2023 to December 2024 were selected. According to the random number table method, they were divided into the control group and the observation group, with 50 patients in each group. The control group received delayed soft tissue closure (submerged technique), and the observation group received early soft tissue closure (non-submerged technique). The completion of healing abutment installation was uniformly taken as the starting point for evaluation. The clinical healing indicators, aesthetic effect, postoperative reactions and infection status were compared between the two groups. Results The soft tissue healing time of the observation group was shorter than that of the control group (P <0.05). There were no significant differences in the rates of incision dehiscence and suture reaction between the two groups (P >0.05). The PES score, papilla filling score, keratinized gingiva width change and postoperative swelling score of the observation group were better than those of the control group (P <0.05). There were no significant differences in VAS score, postoperative bleeding rate, early infection rate, late infection rate and incidence of peri-implantitis between the two groups (P >0.05). Conclusion For primary implant surgery in posterior tooth areas with sufficient bone volume, early soft tissue closure (non-submerged technique) can shorten the soft tissue healing time after abutment installation, relieve postoperative swelling andimprove aesthetic effect, without increasing the risk of postoperative reactions and complications.