Objective: To investigate the effects of different orthodontic treatments on anterior tooth alignment, smile line, and facial soft-tissue aesthetics. Methods: Eighty patients who underwent orthodontic treatment between December 2022 and December 2025 were enrolled and randomly assigned to a control group or an observation group using a random number table, with 40 patients in each group. The control group received conventional fixed orthodontic treatment, whereas the observation group received clear aligner treatment. The maxillary and mandibular anterior irregularity indices, smile-line parameters, facial soft-tissue aesthetic parameters, and oral health-related quality of life were compared between the two groups before and after treatment. Results: After treatment, the maxillary and mandibular anterior irregularity indices decreased, whereas smile-line harmony and facial soft-tissue aesthetic scores improved in both groups compared with the pretreatment values (P<0.05). The observation group had lower maxillary and mandibular anterior irregularity indices and higher smile-arc consonance rate, smile aesthetic score, and facial soft-tissue aesthetic score than the control group (P<0.05). The Oral Health Impact Profile-14 score was lower in the observation group than in the control group (P<0.05), indicating a better oral health-related quality of life. Conclusion: Both conventional fixed appliances and clear aligners can improve anterior tooth alignment and facial aesthetics in patients with malocclusion. Clear aligner treatment provides greater benefits in optimizing anterior tooth alignment, harmonizing the smile line, and improving facial soft-tissue morphology, thereby contributing to a better oral health-related quality of life.