Objective To explore the effect of 3D printing technology-guided interproximal enamel reduction in the orthodontics treatment of patients with malocclusion. Methods A total of 82 patients with malocclusion who received orthodontics treatment in the Department of Orthodontics, Xining Stomatological Hospital from March 2023 to January 2025 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 41 patients in each group. The control group was treated with conventional interproximal enamel reduction, and the observation group was treated with 3D printing technology-guided interproximal enamel reduction. The gray value and hardness value after interproximal enamel reduction, masticatory efffciency, periodontal indexes and orthodontics treatment satisfaction were compared between the two groups. Results After interproximal enamel reduction, the gray value of the observation group was lower than that of the control group, while the hardness value was higher than that of the control group (P<0.05). The masticatory efffciency of the observation group at 6 months after orthodontics treatment was higher than that of the control group (P<0.05). At 6 months after orthodontics treatment, the GI, SBI and PLI of the observation group were lower than those of the control group (P<0.05). The total score of orthodontics treatment satisfaction in the observation group was higher than that in the control group (P<0.05). Conclusion 3D printing technology-guided interproximal enamel reduction has a deffnite effect in the orthodontics treatment of patients with malocclusion. It can achieve precise interproximal enamel reduction of affected teeth, effectively reduce the gray value of dental tissue and increase its hardness value, which is conducive to improving patients' masticatory efffciency and periodontal health status, as well as enhancing orthodontics treatment satisfaction.