Objective To explore the effect of fixed-removable denture restoration in young and middle-aged patients with periodontal disease complicated by dentition defect. Methods A total of 58 young and middle-aged patients with periodontal disease complicated by dentition defect admitted to Rugao Branch of Affiliated Hospital of Nantong University/Rugao Bo'ai Hospital from January 2021 to December 2024 were selected, and they were divided into group A and group B by the random number table method, with 29 patients in each group. Group A received removable denture restoration, and Group B received fixedremovable denture restoration. The restoration effect, masticatory function, aesthetic effect and oral health impact were compared between the two groups. Results The total effective rate of group B (96.55%) was higher than that of group A (72.41%) (P <0.05). After restoration, the maximum occlusal contact area, maximum occlusal force, occlusal force asymmetry index and masticatory efficiency of group B were better than those of group A (P <0.05). After restoration, the scores of WES and PES in group B were higher than those in group A (P <0.05). After restoration, the scores of each dimension of oral health impact in group B were lower than those in group A (P <0.05). Conclusion Fixed-removable denture restoration has a definite effect in young and middle-aged patients with periodontal disease complicated by dentition defect. It can improve masticatory function, enhance aesthetic effect, and help to reduce oral health impact, which is worthy of clinical application.