Objective To investigate the effect of orthodontics combined with fixed denture in the repair of malocclusion combined with dental defects. Methods A total of 62 patients with malocclusion and dentition defect admitted to Xuzhou Aiya Dental Hospital from January to December 2022 were randomly divided into control group and experimental group, with 31 patients in each group. The control group was treated with orthodontics, and the experimental group was treated with orthodontics combined with fixed denture. The clinical indicators, treatment effectiveness and complications of the two groups were compared. Results The scores of masticatory function, speech function, coordination and aesthetics, and comfort of the experimental group were higher than those of the control group (P <0.05). The total effective rate of treatment of the experimental group was 96.77%, which was higher than 77.42% of the control group (P <0.05). The incidence of complications of the experimental group was lower than that of the control group (P <0.05). Conclusion Oral orthodontics combined with fixed denture can improve the masticatory function and speech function of patients with combined malocclusion and dental defects, improve the aesthetics and comfort of dental coordination, and reduce the incidence of complications, with a high degree of safety.