Objective To explore the effect of personalized orthodontics treatment combined with oral aesthetic restoration on occlusal function in patients with tooth defect combined with tooth deformity. Methods A total of 120 patients with tooth defect combined with tooth deformity admitted to the Department of Stomatology of the Third Medical Center of Chinese PLA General Hospital from January 2023 to January 2024 were selected, and they were divided into the observation group and the control group by the random number table method, with 60 patients in each group. The control group received conventional oral aesthetic restoration, and the observation group received personalized orthodontics treatment combined with oral aesthetic restoration. The oral aesthetic effect, masticatory function, restoration retention rate, satisfaction and adverse reaction rate were compared between the two groups. Results At 1 year after treatment, the scores of all dimensions of oral aesthetic effect in the observation group were better than those in the control group (P<0.05). At 1 year after treatment, the maximum occlusal force and masticatory efffciency of the observation group were better than those of the control group (P<0.05). The restoration retention rate of the observation group was 96.67%, which was higher than 86.67% of the control group (P<0.05). The satisfaction rate of the observation group was 98.33%, which was higher than 78.33% of the control group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion Personalized orthodontics treatment combined with oral aesthetic restoration can improve aesthetic effect and occlusal function of patients with tooth defect combined with tooth deformity, effectively increase restoration retention rate and patient satisfaction, without increasing adverse reactions, which is worthy of clinical application.