Objective To explore the aesthetic effect of zirconia all-ceramic crown in the restoration of dentition defect and its influence on periodontal health and masticatory function. Methods A total of 90 patients with dentition defect who received restoration treatment in the Department of Stomatology of our hospital from April 2022 to February 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 45 patients in each group. The control group received cobalt-chromium alloy porcelain-fused-to-metal full crown restoration, and the observation group received zirconia all-ceramic crown restoration. The oral aesthetic effect, periodontal health and masticatory function were compared between the two groups. Results At 6 months after operation, the scores of PES and WES in the observation group were higher than those in the control group (P<0.05). At 6 months after operation, the GI and SBI in the observation group were lower than those in the control group (P<0.05). At 6 months after operation, the masticatory efffciency and occlusal force of the observation group were higher than those of the control group (P<0.05). Conclusion Zirconia all-ceramic crown has definite therapeutic advantages in dentition defect restoration. It can optimize oral aesthetic effect and effectively improve patients’ periodontal health and masticatory function.