Objective To explore the effect of orthodontic-implant combined restoration on masticatory function and aesthetic effect in patients with dentition defect and mild to moderate malocclusion. Methods A total of 66 patients with dentition defect and mild to moderate malocclusion treated at Lianping Xujiaren Dental Clinic from July 2021 to June 2025 were selected, and they were divided into the reference group and the study group by the random number table method, with 33 patients in each group. The reference group received implant restoration alone, and the study group received orthodontic-implant combined restoration. The masticatory function, aesthetic effect and complications were compared between the two groups. Results At 3 months after treatment, the maximum bite force and masticatory efficiency of the study group were higher than those of the reference group (P <0.05). At 3 months after treatment, the scores of PES and WES in the study group were higher than those in the reference group (P <0.05). The incidence of complications in the study group was 3.03%, which was lower than 24.24% in the reference group (P <0.05). Conclusion Orthodontic-implant combined restoration can effectively correct malocclusion in patients with dentition defect and mild to moderate malocclusion, restore normal oral anatomical structure, improve masticatory function and aesthetic performance of restoration, and reduce the risk of postoperative complications.