Objective To investigate the effect of prefabricated fiber post on periodontal indicators and dental aesthetics in patients with large area defect of anterior teeth. Methods A total of 80 patients with large area defect of anterior teeth treated in the Department of Stomatology, Jiangyin People’s Hospital from June 2022 to December 2024 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the experimental group, with 40 patients in each group. The reference group received metal casting post restoration, and the experimental group received prefabricated ffber post restoration. The restoration effect, periodontal indicators, dental aesthetics, adverse reaction rate and satisfaction were compared between the two groups. Results The marginal adaptation, restoration integrity and color matching in the experimental group were better than those in the reference group (P<0.05). After restoration, the GI and SBI in the experimental group were lower than those in the reference group, while the PES score was higher than that in the reference group (P<0.05). The incidence of adverse reactions in the experimental group (7.50%) was lower than that in the reference group (27.50%) (P<0.05). The satisfaction rate in the experimental group (95.00%) was higher than that in the reference group (80.00%) (P<0.05). Conclusion The application of prefabricated ffber post for large area defect of anterior teeth demonstrates excellent restoration effect. It can effectively reduce adverse reactions, improve periodontal indicators, enhance dental aesthetics, and improve patient satisfaction.