Objective To analyze the clinical application efficacy and safety of complex removable partial denture restoration. Methods A total of 80 patients with complex dentition defect admitted to the Department of Stomatology, Shunyi District Tianzhu Town Health Center from September 2023 to September 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 40 patients in each group. The control group received conventional removable partial denture restoration, and the observation group received complex removable partial denture restoration. The masticatory function, restoration efficacy, aesthetic satisfaction, quality of life and adverse reaction rate were compared between the two groups. Results The masticatory efffciency and occlusal force in the observation group were higher than those in the control group (P<0.05). The total effective rate of restoration in the observation group was 95.00%, which was higher than 77.50% in the control group (P<0.05). The aesthetic satisfaction rate in the observation group was 92.50%, which was higher than 75.00% in the control group (P<0.05). The OHIP-14 score after restoration in the observation group was lower than that in the control group (P<0.05). The incidence of adverse reactions in the observation group was 5.00%, which was lower than 20.00% in the control group (P<0.05). Conclusion The effect of complex removable partial denture restoration is better than that of traditional removable partial denture restoration. It can effectively improve masticatory function and quality of life in patients with complex dentition defect, enhance aesthetic satisfaction, with fewer adverse reactions, showing favorable clinical application efffcacy and safety.