Objective To compare the orthodontic effects of extraoral arch and micro-implant anchorage in orthodontic patients. Methods A total of 52 orthodontics children with maxillofacial deformity admitted to our hospital from June to September 2023 were selected as the research subjects, and they were divided into control group and observation group according to the random number table method, with 26 children in each group. All of the selected children received orthodontics, in which the control group was given extraoral arch anchorage, and the observation group was given micro-implant anchorage. The orthodontic effect, complications, periodontal health and periodontal tissue osteoprotegerin were compared between the two groups. Results The orthodontic excellence rate of the observation group was 96.15%, which was higher than 73.08% of the control group (P <0.05). The complication rate of the observation group was 7.69%, which was lower than 26.92% of the control group (P <0.05). The PD, CAL, BI and PLI of the observation group after treatment were lower than those of the control group (P <0.05). The periodontal tissue osteoprotegerin of the observation group after treatment was higher than that of the control group (P <0.05). Conclusion Compared with extraoral arch anchorage, micro-implant anchorage can enhance the orthodontic effect, improve the periodontal health, increase the level of periodontal tissue osteoprotegerin, and reduce the incidence of complications.