Objective To explore the effect of 3D reconstruction pure titanium machined bridge framework combined with zirconia crown based on cone beam computed tomograph on implantation effect in patients undergoing immediate implantation and immediate restoration. Methods A total of 76 patients who underwent immediate implantation and immediate restoration in our hospital from May 2022 to May 2024 were selected, and they were divided into the reference group and the observation group by the random number table method, with 38 patients in each group. The reference group was treated with pure titanium machined bridge framework combined with zirconia crown, and the observation group was treated with 3D reconstruction pure titanium machined bridge framework combined with zirconia crown based on cone beam computed tomograph. The clinically relevant indicators, alveolar crest bone resorption, implant success rate and complication rate were compared between the two groups. Results The operation time of the observation group after treatment was shorter than that of the reference group (P <0.05). There was no statistically significant difference in the duration of postoperative pain and swelling between the two groups (P >0.05). The alveolar crest bone resorption of the observation group after treatment was less than that of the reference group (P <0.05). There was no statistically significant difference in the implant success rate between the two groups (P >0.05). The incidence of complications in the observation group (2.63%) was less than that in the reference group (18.42%) (P <0.05). Conclusion The application of 3D reconstruction pure titanium machined bridge framework combined with zirconia crown based on cone beam computed tomograph in patients undergoing immediate implantation and immediate restoration can achieve a high implant success rate, effectively improve surgical efficiency, reduce alveolar crest bone resorption, and lower the risk of complications.