Objective To explore the effect of micro-implant anchorage screw combined with MBT straight wire appliance technique on masticatory function and periodontal health in patients with malocclusion. Methods A total of 84 patients with malocclusion who visited Shunde Xingtan Donghong Dental Clinic from January 2023 to December 2024 were selected, and they were divided into group A (n=42) and group B (n=42) by the random number table method. Group A was treated with MBT straight wire appliance technique, and group B was treated with micro-implant anchorage screw combined with MBT straight wire appliance technique. The jaw morphology, masticatory function, periodontal health and adverse events were compared between the two groups. Results After treatment, the SNA angle and ANB angle in the two groups were smaller than those before treatment, and those in group B were smaller than those in group A (P<0.05). There was no statistically significant difference in SNB angle between the two groups (P>0.05). After treatment, the masticatory efficiency and occlusal force of the maxillary first molar in the two groups were higher than those before treatment, and those in group B were higher than those in group A (P<0.05). After treatment, the GI, PD and BI in the two groups were lower than those before treatment, and those in group B were lower than those in group A (P<0.05). The incidence of adverse events in group B was 35.71%, which was lower than 76.19% in group A (P<0.05). Conclusion Micro-implant anchorage screw combined with MBT straight wire appliance technique has a good effect in the treatment of malocclusion. It can more effectively improve jaw morphology and masticatory function, maintain periodontal health, and has a lower incidence of adverse events.