Objective To study the effect of fixed orthodontic technique combined with cast porcelain on periodontal status and cosmetic effect of patients with oral cosmetic restoration. Methods A total of 72 patients with oral cosmetic restoration admitted to Zichuan District Hospital of Zibo City from March 2023 to March 2024 were randomly divided into observation group and control group, with 36 patients in each group. The control group was treated with fixed orthodontic technique combined with porcelain crown restoration, and the observation group was treated with fixed orthodontic technique combined with cast porcelain veneer. The cosmetic effect score, periodontal index and complication rate were compared between the two groups. Results After treatment, the scores of color, shape, translucency, edge beauty and total score in the observation group were higher than those in the control group (P <0.05). After treatment, PD, BI, AL and PLI in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group was lower than that in the control group (P <0.05). Conclusion Fixed orthodontic technique and cast porcelain veneer are effective in patients with oral cosmetic restoration, which can improve the cosmetic of teeth, improve the periodontal health status and reduce the incidence of complications.