Objective To analyze the effect of composite resin restoration on dental aesthetics and periodontal indexes in patients with aesthetic restoration of anterior teeth. Methods A total of 46 patients who underwent aesthetic restoration of anterior teeth in our hospital from January 2021 to January 2023 were selected as the research subjects. According to the random number table method, they were divided into the reference group and the study group, with 23 patients in each group. The reference group was treated with nano-composite resin restoration, and the study group was treated with composite resin restoration. The dental aesthetics, periodontal indexes, restoration effect and complications were compared between the two groups. Results After treatment, the scores of tooth morphology, retention, color and surface smoothness in the study group were all lower than those in the reference group (P <0.05). After treatment, the GI, PLI and AL in the study group were all lower than those in the reference group (P <0.05). The total restoration rate of treatment in the study group (95.65%) was higher than that in the reference group (73.91%) (P <0.05). There was no significant difference in the incidence of complications between the two groups (P >0.05). Conclusion The application of composite resin restoration in patients with aesthetic restoration of anterior teeth is effective, which can effectively improve the dental aesthetics, optimize the periodontal indexes, enhance the restoration effect, and ensure the safety of treatment. It is worthy of clinical application.