Objective To explore the effect of refined periodontal soft tissue nursing during peri-restorative period on gingival margin contour and periodontal health in patients with anterior composite resin restoration. Methods A total of 80 patients with single anterior tooth defect who underwent anterior composite resin restoration in our hospital from January to December 2024 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 nursing, and the observation group received refined periodontal soft tissue nursing during perirestorative period on the basis of conventional nursing. The gingival margin contour indicators [gingival zenith deviation (GZD), gingival recession (GR)] and coordination of gingival margin contour, periodontal health [gingival index (GI), sulcus bleeding index (SBI)], restoration quality and aesthetic satisfaction were compared between the two groups. Results After 6 months of nursing, the GZD, GR, GI and SBI in the observation group were lower than those in the control group (P <0.05). The coordination rate of gingival margin morphology in the observation group (90.00%) was higher than that in the control group (65.00%) (P <0.05). The aesthetic satisfaction score of the observation group was higher than that of the control group (P <0.05). There were no significant differences in the acceptable rates of marginal adaptation, surface gloss/discoloration and restoration integrity between the two groups (P >0.05). Conclusion Refined periodontal soft tissue nursing during peri-restorative period can improve gingival margincontour and periodontal health for patients with anterior composite resin restoration, and increase the coordination rate of gingival margin contour and aesthetic satisfaction.