Objective To explore the effect of sandwich osteotomy on implantation effect and aesthetic effect in patients with anterior tooth loss. Methods A total of 40 patients with anterior tooth loss admitted to our hospital from May 2023 to May 2024 were selected, and they were divided into the control group and the study group according to the PSM method, with 20 patients in each group. The control group was treated with secondary-stage anterior tooth implantation and restoration, and the study group was treated with sandwich osteotomy. The implantation effect, bone height, bone resorption rate and aesthetic effect were compared between the two groups. Results The implantation success rate and implant survival rate of the study group were higher than those of the control group (P<0.05). At 6 months after surgery, the bone height of the two groups was higher than that immediately after surgery, and that of the study group was higher than that of the control group (P<0.05). The bone resorption rate of the study group was higher than that of the control group (P<0.05). After surgery, the scores of PES and WES in the two groups were higher than those before surgery, and those in the study group were higher than those in the control group (P<0.05). Conclusion Sandwich osteotomy achieves favorable implantation effect in the repair of anterior tooth loss. It can effectively improve bone height and bone resorption rate, and enhance implantation success rate, implant survival rate and aesthetic effect.