Objective To analyze the effect of local pedicled mucosal attached gingiva reconstruction and free gingival graft on keratinized gingival width in patients undergoing oral implant restoration. Methods A total of 60 patients who underwent oral implant restoration in the Department of Stomatology of our hospital from June 2021 to December 2023 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 30 patients in each group. The control group underwent local pedicled mucosal attached gingiva reconstruction, and the observation group underwent free gingival graft. The implant success rate, pain degree, oral health indicators, keratinized gingival width and quality of life were compared between the two groups. Results The implant success rate of the observation group (90.00%) was lower than that of the control group (96.97%), but the difference was not statistically significant(P >0.05). There was no significant difference in pain degree between the two groups at 3 months after operation (P >0.05). There were no significant differences in plaque index and bleeding index between the two groups at 3 months after operation (P >0.05). The keratinized gingival width of the observation group at 3 months after operation was better than that of the control group (P <0.05). The quality of life score of the observation group at 3 months after operation was higher than that of the control group (P <0.05). Conclusion Both local pedicled mucosal attached gingiva reconstruction and free gingival graft can improve implant success rate, with mild pain and good oral health, but free gingival graft has a better effect in increasing keratinized gingival width and can effectively improv e patients' quality of life.