Objective To investigate the effect of zirconia all-ceramic crown restoration on periodontal health status and masticatory function in patients with anterior teeth defect. Methods A total of 100 patients with anterior teeth defect admitted to our hospital from February 2023 to February 2024 were selected. According to the random number table method, they were divided into group A and group B, with 50 patients in each group. Group A was given gold alloy porcelain crown restoration, and group B was given zirconia all-ceramic crown restoration. The periodontal health status, masticatory function, restoration effect and adverse reactions were compared between the two groups. Results After treatment, GI, PLI and PD in group B were lower than those in group A (P <0.05). After treatment, the masticatory efficiency and occlusal force of group B were higher than those of group A (P <0.05). The excellent and good rates of restoration in tooth color, tooth fracture, marginal fit and gingival health status of group B were higher than those of group A (P <0.05). The incidence of adverse reactions in group B (4.00%) was lower than that in group A (16.00%) (P <0.05). Conclusion The application of zirconia all-ceramic crown in the restoration of anterior teeth defect can effectively improve the periodontal health status of patients, enhance masticatory function, promote the improvement of restoration effect, and has fewer adverse reactions after restoration, which is worthy of clinical application.