Objective To analyze the effect of orthodontic treatment combined with implant anchorage on maxillary anterior aesthetics and dental arch morphology in patients with malocclusion. Methods A total of 84 patients with malocclusion admitted to the Department of Orthodontics, Hangzhou Chengxing Meiao Stomatology from May 2024 to March 2025 were selected as the research subjects. According to different treatment methods, they were divided into the control group and the observation group, with 42 patients in each group. The control group received orthodontic treatment, and the observation group received orthodontic treatment combined with implant anchorage. The maxillary anterior aesthetics, dental arch morphology, restoration effect and adverse reaction rate were compared between the two groups. Results After 12 months of treatment, the molar displacement in the observation group was smaller than that in the control group, and the inclination angle and protrusion distance of the upper central incisor were higher than those of the control group (P<0.05). After 3 and 6 months of treatment, the scores of aesthetics, function and biology in the observation group were lower than those in the control group (P<0.05). The incidence of adverse reactions in the observation group (4.76%) was lower than that in the control group (19.05%) (P<0.05). Conclusion The application of orthodontic treatment combined with implant anchorage in the treatment of malocclusion can improve restoration effect, optimize maxillary anterior aesthetics and dental arch morphology, and reduce the incidence of adverse reactions.