Objective To analyze the effect of pre-restorative orthodontic treatment on dental function and aesthetic effect in patients with dentition defect complicated by malocclusion. Methods A total of 82 patients with dentition defect complicated by malocclusion admitted to Lishui WANG Zhi Dental Clinic from January 2024 to August 2025 were divided into the reference group and the experimental group by the random number table method, with 41 patients in each group. The reference group received implant-supported denture restoration, and the experimental group received pre-restorative orthodontic treatment on the basis of the reference group. The restoration effect, dental function, occlusal function and aesthetic effect were compared between the two groups. Results The excellent and good rate of restoration in the experimental group was 95.12%, which was higher than 80.49% in the reference group (P <0.05). After treatment, the scores of speech function, masticatory function and swallowing function in the experimental group were higher than those in the reference group (P <0.05). After treatment, the occlusal force asymmetry index of the experimental group was lower than that of the reference group, while the maximum occlusal force and maximum occlusal contact area were larger than those of the reference group (P <0.05). After treatment, the scores of WES and PES in the experimental group were higher than those in the reference group (P <0.05). Conclusion The application of pre-restorative orthodontic treatment for patients with dentition defect complicated by malocclusion can effectively improve dental function, increase occlusal force, and enhance aesthetic effect and restoration effect.