Objective To analyze the effect of extraction orthodontics combined with periodontal tissue regeneration surgery on periodontal inffammation level and aesthetics in patients with periodontitis complicated by anterior teeth displacement. Methods A total of 80 patients with periodontitis complicated by anterior teeth displacement admitted to our hospital from January 2020 to August 2023 were selected, and they were divided into the reference group and the study group by the random number table method, with 40 patients in each group. The reference group was treated with periodontal tissue regeneration surgery, and the study group was treated with extraction orthodontics combined with periodontal tissue regeneration surgery. The periodontal inflammation level, aesthetics, periodontal indicators and complications were compared between the two groups. Results At 6 months after treatment, the levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α in the study group were lower than those in the reference group (P<0.05). At 6 months after treatment, the scores of PES and WES in the study group were higher than those in the reference group (P<0.05). At 6 months after treatment, the scores of gingival index, bleeding index, plaque index and periodontal probing depth in the study group were lower than those in the reference group (P<0.05). The incidence of complications in the study group (12.50%) was higher than that in the reference group (10.00%), but the difference was not statistically signiffcant (P>0.05). Conclusion Extraction orthodontics combined with periodontal tissue regeneration surgeryin the treatment of periodontitis complicated by anterior teeth displacement can reduce periodontal inffammation level, improve periodontal-related indicators, enhance aesthetic effect, and does not increase the risk of complications.