Objective To analyze the effect of fixed orthodontic technique combined with cast porcelain veneer in patients with oral cosmetic restoration. Methods A total of 40 patients with oral cosmetic restoration admitted to our hospital from January 2020 to December 2023 were randomly divided into experimental group and reference group, with 20 patients in each group. The reference group received conventional porcelain crown treatment, and the experimental group received fixed orthodontic technology combined with cast porcelain veneer treatment. The periodontal status, tooth aesthetics, and complications were compared between the two groups. Results The periodontal pocket, gingival bleeding index, periodontitis and plaque index in the experimental group were lower than those in the reference group (P <0.05). After treatment, the scores of color, shape, edge beauty and translucency in the experimental group were higher than those in the reference group (P <0.05). The incidence of complications in the experimental group was lower than that in the reference group (P <0.05). Conclusion The implementation of fixed orthodontic technique combined with cast porcelain veneer in patients with oral cosmetic restoration is helpful to improve their periodontal status and cosmetic effect, as well as reduce the incidence of complications.