Objective To compare the efffcacy and safety of all-ceramic restoration and porcelain-fused-to-metal restoration in oral restoration. Methods A total of 70 patients who underwent oral restoration at Kunshan Mental Health Center from September 2021 to September 2025 were selected, and they were divided into the control group and the study group by the random number table method, with 35 patients in each group. The control group received porcelain-fused-to-metal restoration, and the study group received all-ceramic restoration. The restoration effect, masticatory function, complication rate and restoration satisfaction were compared between the two groups. Results The excellent and good rates of marginal adaptation, restoration integrity, tooth color matching and periodontal tissue status in the study group were higher than those in the control group (P<0.05). At 1 month after restoration, the occlusal force and masticatory efficiency in the study group were higher than those in the control group (P<0.05). The incidence of complications in the study group (5.71%) was lower than that in the control group (25.71%) (P<0.05). The restoration satisfaction rate in the study group (97.14%) was higher than that in the control group (80.00%) (P<0.05). Conclusion In oral restoration, all-ceramic restoration can improve patients' masticatory function, enhance restoration effect and satisfaction, and reduce the risk of complications. All-ceramic restoration shows superior efficacy and safety compared with porcelain-fused-to-metal restoration.