Objective To analyze the effect of minimally invasive resin aesthetic restoration on dentin hypersensitivity and periodontal indicators in patients with anterior enamel defect. Methods A total of 80 patients with anterior enamel defect admitted to the No.1 People' s Hospital of Shizuishan from February 2023 to February 2025 were selected, and they were divided into the control group and the observation group by the random number table method, with 40 patients in each group. The control group received conventional resin filling restoration, and the observation group received minimally invasive resin aesthetic restoration. The dentin hypersensitivity, periodontal indicators, restoration effect and subjective aesthetic satisfaction were compared between the two groups. Results At 12 months of follow-up, the dentin sensitivity score of the observation group was lower than that of the control group (P <0.05). At 12 months of follow-up, the PLI and BI of the observation group were lower than those of the control group (P <0.05). The qualified rates of restoration integrity, marginal adaptation, marginal discoloration and color matching in the observation group were higher than those in the control group (P <0.05). The subjective aesthetic satisfaction rate in the observation group (90.00%) was higher than that of the control group (60.00%) (P <0.05). Conclusion Minimally invasive resin aesthetic restoration for patients with anterior enamel defect can improve the long-term clinical qualification rate of restorations, reduce postoperative dentin hypersensitivity, help to maintain periodontal tissue health, and improve patients' subjective aesthetic satisfaction.