Objective To explore the effect of fixed-removable denture restoration on restoration effect and aesthetic effect in young and middle-aged patients with periodontal disease complicated by dentition defect. Methods A total of 70 young and middleaged patients with periodontal disease complicated by dentition defect admitted to the Department of Stomatology, Mianxian Hospital from June 2020 to May 2025 were selected, and they were divided into group A and group B by the random number table method, with 35 patients in each group. Group A received removable denture restoration, and group B received fixed-removable denture restoration. The restoration effect, masticatory function, tooth mobility, aesthetic effect and adverse reactions of denture restoration were compared between the two groups. Results At 5 months after treatment, the excellent and good rate of short-term and medium-term efficacy in group B (97.14%) was higher than that in group A (82.86%) (P <0.05). At 5 months after treatment, the masticatory efficiency and the scores of PES and WES in the two groups were higher than those before treatment, and those in group B were higher than those in group A (P <0.05). At 5 months after treatment, the PTV score of the two groups was lower than that before treatment, and that of group B was lower than that of group A (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P >0.05). Conclusion Both restoration methods are suitable for young and middle-aged patients with periodontal disease complicated by dentition defect. Fixed-removable denture restoration has more advantages in improving masticatory function, enhancing tooth stability and aesthetic effect, and can improve the overall restorationeffect, without increasing the incidence of adverse reactions.