Objective To explore the effects of guided eruption surgery and orthodontic treatment on alveolar integrity and dental aesthetics in patients with impacted maxillary anterior teeth. Methods A total of 86 patients with impacted maxillary anterior teeth from January 2025 to June 2026 admitted to Suzhou Stomatological Hospital were selected, and randomly divided into the control group (n=43, conventional guided eruption surgery) and the study group (n=43, guided eruption surgery and orthodontic treatment). The treatment duration, alveolar integrity, mouth opening limitation, chewing efficiency, occlusal force, and dental aesthetics in both groups were compared. Results Compared to the control group, the gingival exposure time and overall treatment time in the study group were shorter (P＜0.05). At 7 days postoperatively, the alveolar integrity score and mouth opening limitation were lower (P＜0.05). One month after eruption, the chewing efficiency, occlusal force, and red aesthetic score (PES) were higher (P＜0.05). Conclusion Guided eruption surgery and orthodontic treatment can shorten the treatment cycle for patients with impacted maxillary anterior teeth, reduce the impact of surgery on alveolar bone and mouth opening, improve chewing function, and enhance gingival aesthetic outcomes.