Objective To explore the effect of cast porcelain veneer technology on periodontal health status and aesthetic effect in patients undergoing oral aesthetic restoration. Methods A total of 50 patients who received oral aesthetic restoration in Lianyungang Chinese Medicine Hospital from January to December 2024 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the experimental group, with 25 patients in each group. The reference group was treated with porcelain-fused-to-metal crown technology, and the experimental group was treated with cast porcelain veneer technology. The periodontal health status, aesthetic effect, clinical efffcacy and adverse reaction rate were compared between the two groups. Results At 6 months after restoration, the BI, AL and PD in the experimental group were lower than those in the reference group (P<0.05). At 3 and 6 months after restoration, the scores of aesthetic effect in the experimental group were higher than those in the reference group (P<0.05). The total effective rate of the experimental group (96.00%) was higher than that of the reference group (76.00%) (P<0.05). The incidence of adverse reactions in the experimental group (8.00%) was lower than that in the reference group (32.00%) (P<0.05). Conclusion Cast porcelain veneer technology exhibits favorable clinical efficacy in oral aesthetic restoration. It can effectively improve patients' periodontal health status, enhance oral aesthetics, and has the advantage of fewer adverse reactions.