Objective To compare the effects of all-ceramic inlay restoration and direct composite resin filling restoration for maxillary anterior tooth defect. Methods A total of 100 patients with maxillary anterior tooth defect admitted to our hospital from January 2024 to January 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 50 patients in each group. The control group received direct composite resin filling restoration, and the observation group received all-ceramic inlay restoration. The tooth appearance restoration effect, tooth function recovery, satisfaction and adverse reaction rate were compared between the two groups. Results The scores of tooth appearance restoration effect in the observation group were higher than those in the control group (P <0.05). The scores of tooth function recovery in the observation group were higher than those in the control group (P <0.05). The satisfaction of the observation group (94.00%) was higher than that of the control group (72.00%) (P <0.05). The incidence of adverse reactions in the observation group (12.00%) was lower than that in the control group (34.00%) (P <0.05). Conclusion Compared with direct composite resin filling restoration, all-ceramic inlay restoration has a better effect on maxillary anterior tooth defect. It can improve tooth appearance, promote tooth function recovery, help to improve restoration satisfaction and reduce adverse reactions, which is worthy of clinical application.