Objective To analyze the effect of closed traction combined with orthodontic treatment on impacted upper anterior teeth. Methods A total of 60 patients with impacted upper anterior teeth admitted to Suzhou Stomatological Hospital from January 2022 to December 2023 were selected as the research objects. They were divided into control group and observation group by random number table method, with 30 patients in each group. The control group was treated with open traction and orthodontic treatment, and the observation group was treated with closed traction and orthodontic treatment. The clinical efficacy, perioperative indicators, oral function, periodontal indicators, inflammatory factor levels, adverse reactions and aesthetics were compared between the two groups. Results The total effective rate of treatment in the observation group was 100.00%, which was higher than 93.33% in the control group, but the difference was not statistically significant (P >0.05). There was no significant difference in operation time between the two groups (P >0.05). The swelling degree and recovery time of swelling in the observation group were better than those in the control group, and the VAS score at 1 day after operation was lower than that in the control group (P <0.05). The scores of chewing function, pronunciation function and protrusive occlusal relationship in the observation group were higher than those in the control group (P <0.05). There was no significant difference in clinical attachment level between the two groups after treatment (P >0.05), but the probing depth, gingival index and gingival sulcus bleeding index in the observation group were lower than those in the control group (P <0.05). The levels of MMP-8, MMP-2 after treatment in the observation group were lower than those in the control group (P <0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, the difference was statistically significant (P <0.05). The scores of PES and WES in the observation group were higher than those in the control group, and the differences were statistically significant (P <0.05). Conclusion Compared with open traction orthodontic treatment, closed traction combined with orthodontic treatment has similar effects, but it has certain advantages in reducing pain, promoting periodontal recovery and aesthetics, and has the effect of reducing potential adverse events.