Objective To investigate the effect of one-appointment root canal therapy in patients with oral restoration and its influence on the aesthetics of patients' teeth. Methods From December 2022 to December 2023, 60 patients who underwent oral restoration in Changshu Xingmang Dental Clinic were randomly divided into control group and observation group, with 30 patients in each group. The control group was treated with multiple root canal therapy, and the observation group was treated with oneappointment root canal therapy. The clinical efficacy, masticatory function, gingival index, inflammatory factor level, complications and satisfaction were compared between the two groups. Results The total effective rate of treatment in the observation group was 96.67%, which was higher than 66.67% in the control group (P <0.05). After treatment, the bite force and masticatory function of the observation group were higher than those of the control group (P <0.05). The gingival index of the observation group was lower than that of the control group after treatment (P <0.05). After treatment, the levels of IL-6, CRP and TNF-α in the observation group were lower than those in the control group (P <0.05). The incidence of complications in the observation group was 3.33%, which was lower than 23.33% in the control group (P <0.05). The satisfaction of edge tightness, good fixation, color matching and smooth surface in the observation group was higher than that in the control group (P <0.05). Conclusion One-appointment root canal therapy is effective in patients with oral restoration, which can effectively improve the aesthetics and masticatory function of teeth, reduce the inflammatory reaction, improve the health level of gums, and patients' satisfaction with the repair effect is high, which is worthy of clinical application.