Objective: To investigate the effect of microscrew implant anchorage on root resorption, masticatory function, and aesthetic outcomes in patients undergoing orthodontic treatment. Methods:Sixty-two patients who received orthodontic treatment at the hospital between January 2019 and December 2023 were selected and randomly divided into two groups using a random number table: the control group (n=31) received extraoral high-pull headgear anchorage, while the study group (n=31) received microscrew implant anchorage. The two groups were compared and analyzed in terms of root resorption, masticatory function, aesthetic outcomes, and complication rates. Results:Before treatment, there was no significant difference in the volume ratio of the maxillary and mandibular central incisors, lateral incisors, and canines between the two groups (P>0.05). After treatment, the tooth volumes in both groups decreased compared to pre-treatment values (P<0.05), but no significant difference was observed between the groups (P>0.05). Before treatment, there was no significant difference in masticatory function measurements and aesthetic scores between the two groups (P>0.05). After treatment, both masticatory function measurements and aesthetic scores improved compared to pre-treatment levels, with the study group showing significantly higher values than the control group (P<0.05). The complication rate in the study group was significantly lower than that in the control group (P<0.05). Conclusion:The application of microscrew implant anchorage in orthodontic treatment can help control root resorption, improve masticatory function and aesthetic outcomes, and reduce the risk of complications.