Objective To analyze the effect of orthodontics combined with implant restoration on periodontal indices in patients with dentition defect combined with malocclusion. Methods A total of 80 patients with dentition defect and malocclusion admitted to Xuzhou Aiya Stomatological Hospital from January 2023 to June 2025 were selected. According to the random number table method, they were divided into group A and group B, with 40 patients in each group. Group A received implant restoration alone, and group B received orthodontics combined with implant restoration. The clinical efficacy, periodontal indices, occlusal function, masticatory efficiency and complication rate were compared between the two groups. Results The total effective rate of group B (95.00%) was higher than that of group A (77.50%) (P <0.05). After treatment, all periodontal indices in group B were better than those in group A (P <0.05). After treatment, the occlusal function and masticatory efficiency in group B were better than those in group A (P <0.05). The incidence of complications in group B (7.50%) was lower than that in group A (25.00%) (P <0.05). Conclusion For patients with dentition defect combined with malocclusion, the application of orthodontics combined with implant restoration can improve clinical efficacy, optimize periodontal health, enhance occlusal function and masticatory efficiency, and effectively reduce the incidence of complications.