Objective To analyze the effect of zirconia all-ceramic crown restoration on aesthetic effect and masticatory function in patients with dentition defect. Methods A total of 80 patients with dentition defect admitted to Cangzhou Nandagang Hospital from March 2023 to February 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 40 patients in each group. The control group was treated with pure titanium porcelain-fused-to-metal crown restoration, and the observation group was treated with zirconia all-ceramic crown restoration. The aesthetic effect, masticatory function, periodontal status and adverse reaction rate were compared between the two groups. Results The scores of aesthetic effect in the observation group were higher than those in the control group (P<0.05). The occlusal force and masticatory efficiency of the observation group at 3 months after restoration were better than those of the control group (P<0.05). The periodontal pocket depth and plaque index of the observation group at 3 months after restoration were lower than those of the control group (P<0.05). The incidence of adverse reactions in the observation group (2.50%) was lower than that in the control group (20.00%) (P<0.05). Conclusion Compared with pure titanium porcelain-fused-to-metal crown, zirconia all-ceramic crown restoration for dentition defect can effectively improve the aesthetic effect, promote the recovery of patients' masticatory function, ameliorate periodontal status, and reduce the incidence of adverse reactions.