Objective To compare the aesthetic effect between laterally positioned ffap and coronally advanced ffap after epulis resection in patients with maxillary anterior region epulis. Methods A total of 68 patients with maxillary anterior region epulis admitted to Stomatological Hospital Afffliated to Suzhou Vocational Health College from February 2024 to January 2025 were selected as the research subjects. According to different treatment protocols, they were divided into group A and group B, with 34 patients in each group. Group A was treated with laterally positioned ffap repair after epulis resection, and group B was treated with coronally advanced ffap repair after epulis resection. The periodontal functional indicators, aesthetic effect and satisfaction were compared between the two groups. Results At 3 and 6 months after operation, the width of keratinized gingiva in group A was higher than that in group B, the probing depth was lower than that in group B, and the root surface coverage was better than that in group B (P<0.05). There was no statistically signiffcant difference in gingival bleeding index between the two groups (P>0.05). At 3 and 6 months after operation, the scores of PES in group A were higher than those in group B (P<0.05). There was no signiffcant difference in intraoperative experience satisfaction between the two groups (P>0.05). The postoperative dental aesthetic satisfaction of group A was higher than that of group B (P<0.05). Conclusion For patients with maxillary anterior region epulis, laterally positioned flap repair following epulis resection contributes to the recovery of periodontal function, achieves favorable aesthetic effect, and improves patients’ satisfaction with dental appearance.