Objective To evaluate the clinical effect of SonicFill ultrasonic resin combined with transparent preformed crown in the aesthetic restoration of primary anterior teeth. Methods A total of 62 patients with primary anterior tooth defect who visited the Department of Stomatology, Haiyan Stomatological Hospital from April 2023 to May 2025 were selected, and they were divided into the control group and the experimental group by the random number table method, with 31 patients in each group. The control group received traditional light-curing resin direct filling restoration, and the experimental group received SonicFill ultrasonic resin combined with transparent preformed crown restoration. The aesthetic effect, restoration integrity and periodontal health were compared between the two groups. Results The scores of color matching, morphological coordination, marginal adaptation and total aesthetic effect score of the experimental group were higher than those of the control group (P<0.05). The restoration integrity rate of the experimental group was 96.77%, which was higher than 77.42% of the control group (P<0.05). The scores of gingival color, gingival bleeding, periodontal pocket depth and total periodontal health score of the experimental group were higher than those of the control group (P<0.05). Conclusion The application of SonicFill ultrasonic resin combined with transparent preformed crown in the aesthetic restoration of primary anterior teeth can improve the aesthetic effect, enhance the stability of the restoration, and optimize periodontal health. This combined restoration scheme can be used as one of the preferred schemes for the restoration of primary anterior tooth defect.