Objective To analyze the effects of zirconia all-ceramic crowns and cobalt-chromium alloy porcelain crown on aesthetic degree and periodontal indexes in patients undergoing dental restoration. Methods A total of 108 patients who received dental restoration treatment in our hospital from January 2021 to January 2024 were selected as the research subjects, and they were divided into the control group (n =54) and the observation group (n =54) by the random number table method. The control group was treated with cobalt-chromium alloy porcelain crown, and the observation group was treated with zirconia all-ceramic crown. The aesthetic degree, periodontal indexes, gingival crevicular fluid indexes, quality of life and complications were compared between the two groups. Results The scores of facial condition, overall aesthetic degree, tooth shape and tooth color in the observation group were higher than those in the control group (P <0.05). After intervention, the PLI, SBI and PD in the observation group were lower than those in the control group (P<0.05). After intervention, the GCF content, YKL-40 and resistin in the observation group were lower than those in the control group (P<0.05). After intervention, the quality of life score in the observation group was higher than that in the control group (P<0.05). The incidence of complications in the observation group was 1.85%, which was lower than 12.96% in the control group (P<0.05). Conclusion For patients undergoing dental restoration, the application of zirconia all-ceramic crown can effectively reduce complications, improve periodontal indexes and gingival crevicular fluid indexes, and help to enhance the aesthetic degree of teeth and the overall restoration effect, which is worthy of clinical application.