Objective To analyze the effect of zirconia all-ceramic crown in anterior teeth aesthetic restoration and its impact on periodontal health index. Methods A total of 60 patients with anterior teeth defect admitted to Zhongshan CHEN Wenrui Dental Clinic from January 2021 to January 2024 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 30 patients in each group. The control group was given Co-Cr alloy porcelain crown restoration, and the observation group was given zirconia all-ceramic crown restoration. The periodontal health index, restoration effect and adverse reactions were compared between the two groups. Results The plaque index and sulcus bleeding index of the observation group were lower than those of the control group (P <0.05). The gingival health, restoration shape and aesthetic index of the observation group were lower than those of the control group (P <0.05). There was no significant difference in the restoration fixation and edge suitability between the two groups (P >0.05). The incidence of adverse reactions in the observation group was 3.33%, which was lower than that 26.67% in the control group (P <0.05). Conclusion The application of zirconia all-ceramic crown in anterior teeth aesthetic restoration is effective, which can effectively improve the periodontal health status of patients and enhance the restoration effect. The incidence of adverse reactions after repair is low, and the application safety is high.