Objective To explore the effect of immediate implant restoration combined with orthodontics on aesthetic effect in patients with malocclusion. Methods A total of 68 patients with malocclusion admitted to our clinic from January 2022 to May 2023 were selected as the research subjects. According to the random number table method, they were divided into the control group and the experimental group, with 34 patients in each group. The control group was treated with immediate implant restoration, and the experimental group was treated with orthodontics on the basis of the control group. The aesthetic index (PES), implant stability quotient (ISQ), temporomandibular joint space parameters and complications were compared between the two groups. Results The PES scores at 3 and 6 months after surgery in the experimental group were higher than those in the control group (P <0.05). The ISQ scores at 3 and 6 months after surgery in the experimental group were higher than those in the control group (P <0.05). After treatment, the temporomandibular joint space parameters in the experimental group were all better than those in the control group (P <0.05). The incidence of complications in the experimental group (2.94%) was lower than that in the control group (8.82%) (P <0.05). Conclusion Immediate implant restoration combined with orthodontics has a definite effect on malocclusion, with better aesthetic effect and more stable implants. It can better improve the anatomical structure of the temporomandibular joint, and the risk of complications is low, which is worthy of clinical application.