Objective To analyze the effect of biologically oriented preparation technique on periodontal status and gingival thickness in patients undergoing all-ceramic crown restoration. Methods A total of 80 patients who underwent all-ceramic crown restoration in Lanzhou Stomatological Hospital from September 2022 to September 2024 were selected, and they were divided into the control group and the study group by the random number table method, with 40 patients in each group. The control group adopted traditional preparation technique, and the study group adopted biologically oriented preparation technique (BOPT). The periodontal status, gingival thickness and satisfaction were compared between the two groups. Results The periodontal probing depth of the study group at T1 and T2 was lower than that of the control group (P <0.05). The positive rate of bleeding on probing in the study group was 2.50%, which was lower than 17.50% in the control group (P <0.05). The proportion of marginal stability in the study group was 97.50%, which was higher than 77.50% in the control group (P <0.05). The gingival thickness of the study group at T1 and T2 was higher than that of the control group (P <0.05). The scores of aesthetic effect, comfort and overall satisfaction in the study group were higher than those in the control group (P <0.05). Conclusion Compared with traditional preparation technique, BOPT can more effectively promote the health and stability of periodontal soft tissues after all-ceramic crown restoration, induce adaptive thickening of gingival tissues, and achieve higher patient satisfaction, making it a more advantageous tooth preparation concept.