Objective To analyze the effect of orthodontics combined with surgical guided eruption surgery on alveolar bone density in patients with impacted upper anterior teeth. Methods A total of 120 patients with impacted upper anterior teeth admitted to Linqu Jinpin Dental Clinic from November 2022 to January 2023 were selected as the research subjects, and they were divided into the control group and the experimental group by the random number table method, with 60 patients in each group. The control group was given surgical guided eruption surgery, and the experimental group was given orthodontics combined with surgical guided eruption surgery. The alveolar bone density, treatment efficacy and aesthetic satisfaction were compared between the two groups. Results The alveolar bone density of the experimental group at 6 months after treatment was higher than that of the control group (P <0.05). The total treatment effective rate of the experimental group was 95.00%, which was higher than 75.00% of the control group (P <0.05). The aesthetic satisfaction rate of the experimental group was 96.67%, which was higher than 80.00% of the control group (P <0.05). Conclusion Orthodontics combined with surgical guided eruption surgery has a good effect in the treatment of patients with impacted upper anterior teeth. It can improve alveolar bone density, promote anterior tooth eruption, enhance the treatment effect, and achieve high aesthetic satisfaction, which is worthy of clinical application.