Objective To compare the effects of immediate implant restoration and conventional implant restoration on implant stability in the anterior region of patients with periodontal disease. Methods A total of 86 patients with periodontal disease diagnosed and treated in the Department of Stomatology, Huaihe Hospital of Henan University from January 2022 to September 2023 were selected, and they were divided into the control group (43 patients, 51 implants) and the study group (43 patients, 52 implants) by the random number table method. The control group received conventional implant restoration, and the study group received immediate implant restoration. The implant stability, probing depth (PD), cervical bone resorption, aesthetic effect, implant success rate and complication rate were compared between the two groups. Results There were no statistically signiffcant differences in ISQ between the two groups at the time of restoration placement and 2 years after restoration (P>0.05). The ISQ of the study group at 1 year after restoration was higher than that of the control group (P<0.05). There were no statistically signiffcant differences in PD and cervical bone resorption between the two groups at the time of restoration placement and 2 years after restoration (P>0.05). The PD and cervical bone resorption of the study group at 1 year after restoration were higher than those of the control group (P<0.05). There were no statistically signiffcant differences in PES score between the two groups at the time of restoration placement and 2 years after restoration (P>0.05). The PES score of the study group at 1 year after restoration was higher than that of the control group (P<0.05). The implant success rate in the study group was 98.08%, compared with 96.08% in the control group, the difference was not statistically signiffcant (P>0.05). The incidence of complications in the study group was 5.77%, which was lower than 29.41% in the control group (P<0.05). Conclusion The overall effects of immediate implant and conventional implant in the anterior region of patients with periodontal disease are comparable at the time of restoration placement and 2 years after restoration, and both have high implant success rates. However, immediate implant restoration shows better performance in ISQ and aesthetic effect at 1 year after restoration, with a lower incidence of complications.