Objective To explore the application effect of zirconia all-ceramic crowns in maxillary anterior tooth restoration and its inffuence on aesthetic index. Methods A total of 76 patients who underwent maxillary anterior tooth restoration in Zhongning Maternal and Child Health Care and Family Planning Service Center from March 2024 to March 2026 were selected, and they were divided into the control group and the study group by the random number table method, with 38 patients in each group. The control group received cobalt-chromium alloy porcelain-fused-to-metal crown restoration, and the study group received zirconia all-ceramic crown restoration. The restoration effect, aesthetic index, masticatory function and complication rate were compared between the two groups. Results The proportions of Grade A in restoration color, marginal adaptation and secondary caries of the study group were higher than those of the control group (P<0.05). After treatment, the white aesthetic score, pink aesthetic score, masticatory efffciency and occlusal force of the study group were higher than those of the control group (P<0.05). The incidence of complications in the study group was lower than that in the control group (P<0.05). Conclusion The application of zirconia all-ceramic crown restoration technology in maxillary anterior tooth restoration can improve the overall restoration effect, optimize masticatory function and aesthetic index, and reduce the incidence of complications.