Objective To explore the effect of surgical guided eruption surgery combined with orthodontic treatment on alveolar bone morphology in patients with multiple impacted teeth. Methods A total of 88 patients with multiple impacted teeth treated in Afffliated Stomatological Hospital of Yiyang Medical College from January 2020 to January 2025 were selected as the research subjects, and they were divided into the reference group and the study group by the random number table method, with 44 patients in each group. The reference group received surgical guided eruption, and the study group received surgical guided eruption surgery combined with orthodontic treatment. The alveolar bone morphology, pain intensity, periodontal health status and complication rate were compared between the two groups. Results The lingual alveolar bone height loss and labial alveolar bone height loss in the study group after treatment were lower than those in the reference group (P<0.05). The pain score in the study group after treatment was lower than that in the reference group (P<0.05). The periodontal pocket probing depth and gingival index in the study group after treatment were lower than those in the reference group (P<0.05). The incidence of complications in the study group (4.55%) was lower than that in the reference group (20.45%) (P<0.05). Conclusion For patients with multiple impacted teeth, the application of surgical guided eruption combined with orthodontic treatment can not only effectively improve alveolar bone morphology and relieve pain, but also reduce the incidence of complications, and ffnally promote the improvement of periodontal health.