Objective To investigate the effect of pure titanium casting framework removable partial denture combined with basic periodontal treatment in patients with periodontal disease and Kennedy class Ⅱ dentition defect and its inffuence on masticatory function and periodontal health indicators. Methods A total of 86 patients with periodontal disease and Kennedy class Ⅱ dentition defect admitted to the Second Afffliated Hospital of Hubei University of Science and Technology from January 2023 to June 2024 were selected, and they were divided into the control group (n=43) and the observation group (n=43) by the random number table method. The control group received conventional basic periodontal treatment+ffxed denture, and the observation group received conventional basic periodontal treatment+pure titanium casting framework removable partial denture. The treatment effect, masticatory function and periodontal health indicators were compared between the two groups. Results The total effective rate of treatment in the observation group (97.67%) was higher than that in the control group (81.40%) (P<0.05). After restoration, the occlusal force and masticatory efffciency in the observation group were higher than those in the control group (P<0.05). After restoration, the PD, PLI and SBI in the observation group were lower than those in the control group (P<0.05). Conclusion Pure titanium casting framework removable partial denture combined with basic periodontal treatment is effective in the treatment of periodontal disease and Kennedy class Ⅱ dentition defect, which can effectively improve patients' masticatory function and periodontall health status.