Objective To analyze the effect of modified crown lengthening surgery on periodontal health and dental aesthetics in patients undergoing aesthetic restoration of upper anterior teeth. Methods A total of 58 patients who underwent aesthetic restoration of upper anterior teeth in Yinchuan Stomatology Hospital from January 2023 to September 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 29 patients in each group. The control group received traditional crown lengthening surgery, and the observation group received modified crown lengthening surgery. The periodontal health, dental aesthetics, restoration effect and satisfaction were compared between the two groups. Results After operation, the GI and PPD of the two groups were lower than before operation, and those of the observation group were lower than those of the control group (P <0.05). After operation, the dental aesthetics score of the two groups was higher than that before operation, and that of the observation group was higher than that of the control group (P <0.05). The total effective rate of restoration in the observation group (100.00%) was higher than that in the control group (86.21%) (P <0.05). The satisfaction rate of the observation group (100.00%) was higher than that of the control group (82.76%) (P <0.05). Conclusion The application of modified crown lengthening surgery in the aesthetic restoration of upper anterior teeth can effectively improve the periodontal health of patients, enhance the dental aesthetics after restoration. The restoration effect is definite, and it is beneficial to improving the satisfaction of patients, which is worthy of clinical applicati on.