Objective To compare the effects of aesthetic layered resin restoration and conventional direct resin restoration on aesthetic effect and clinical quality in patients with anterior tooth defect. Methods A total of 86 patients (102 affected teeth) with anterior tooth defect treated in the Department of Stomatology, Zhangjiagang Guanghe Hospital of Integrated Chinese and Western Medicine from January 2023 to June 2024 were selected as the research subjects. According to the random number table method, they were divided into the control group and the observation group, with 43 patients (51 affected teeth) in each group. The control group received conventional direct resin restoration, and the observation group received aesthetic layered resin restoration. The aesthetic effect, clinical quality, periodontal health, color matching and incidence of postoperative sensitivity were compared between the two groups. Results After treatment, the scores of marginal discoloration, marginal adaptation, secondary caries and overall aesthetics of restorations in the observation group were better than those in the control group (P<0.05). The scores of GI and PLI in the observation group after treatment were lower than those in the control group (P <0.05). The color matching score in the observation group after treatment was higher than that in the control group (P<0.05). The incidence of postoperative sensitivity in the observation group was 3.92%, which was lower than 15.69% in the control group (P<0.05). Conclusion For the restoration of anterior tooth defect, the application of aesthetic layered resin restoration can ameliorate marginal discoloration, marginal adaptation and secondary caries, improve the overall aesthetics and color matching of restorations, and reduce postoperative sensitivity, gingival inflammation and plaque accumulation.