Objective To explore the effect of Ceramage polymeric porcelain veneer restoration on periodontal related indexes in the aesthetic treatment of vital pulp anterior teeth. Methods A total of 68 patients who received aesthetic treatment of vital pulp anterior teeth in the Department of Stomatology, Zhumadian Central Hospital from February 2024 to March 2025 were selected. According to the random number table method, they were divided into the control group and the observation group, with 34 patients in each group. The control group was treated with light-curing composite resin, and the observation group was treated with Ceramage polymeric porcelain veneer restoration. The restoration effect, periodontal related indexes and restoration satisfaction were compared between the two groups. Results The scores of restoration integrity, color matching with adjacent teeth, marginal adaptability, pulp status, abutment tooth sensitivity and restoration staining resistance in the observation group were higher than those in the control group (P<0.05). After restoration, the GI, SBI, PLI and PD in the observation group were lower than those in the control group (P<0.05). The restoration satisfaction score of the observation group was (95.08±1.21)points, which was higher than (85.78±4.79)points of the control group (P<0.05). Conclusion Ceramage polymeric porcelain veneer restoration has a reliable effect in the aesthetic treatment of vital pulp anterior teeth. It helps to reduce the impact on periodontal related indexes, maintain good periodontal status, and improve restoration satisfaction.