PURPOSE: To investigate the clinical efficacy of full crown and porcelain inlay in the treatment of cracked teeth after root canal treatment and repair and its effect on chewing ability and gingival status. METHODS: A prospective study was conducted to select 106 patients with cracked teeth who underwent root canal treatment from December 2020 to December 2023, divided into experimental group and control group according to the random number table method, with 53 cases in each group. The clinical effects and adverse reactions of the two groups were counted and compared. The pain levels [visual analogue scale (VAS)] of the two groups before treatment,1 st, 3 rd and 7 th day after treatment were compared. The gingival conditions [plaque index (PLI), gingival index (GI), gingival bleeding index (BI) and periodontal pocket depth (PD)] were compared between the two groups before treatment and after 6 months of follow-up. The chewing ability (bite force, chewing efficiency) of the two groups before treatment, 1 month, 3 months and 6 months of follow-up were compared.Statistical analysis was performed with SPSS 25.0 software package. RESULTS: The good rate of the experimental group was higher than that of the control group, and the total incidence of adverse reactions was lower than that of the control group(P＜0.05). At the 1st, 3rd and 7th day after treatment, VAS scores of the two groups were significantly lower than those before treatment. The experimental group[(4.43±0.68), (3.15±0.63) and (2.04±0.51) points] were significantly lower than the control group[(4.86±0.57), (3.81±0.67) and (2.86±0.52) points], all showed a downward trend (P＜0.05). At 6 months of follow-up, BI and PD in the two groups were higher than those before treatment, GI and PLI were lower than those before treatment. GI, PLI, BI and PD in the experimental group were significantly lower than those in the control group(P＜0.05). After 1, 3 and 6 months of follow up, the masticatory efficiency and bite force of the two groups were higher than those before treatment. The masticatory efficiency of the experimental group was (70.25±5.57)%, (85.36±6.74)% and (92.57±6.35)%, which was significantly higher than that of the control group[(62.35±5.44)%, (73.57±6.32)% and (84.26±6.22)%]. The bite force in the experimental group[(112.52±9.67), (130.52±11.58) and (143.54±13.40) Ibs] were significantly higher than those in the control group[(98.53±9.47) , (113.25±10.54) and (125.36±12.46) Ibs], all of which showed an upward trend (P＜0.05). CONCLUSIONS: The clinical efficacy of porcelain inlays for cracked teeth after root canal treatment and repair is better than that of full crown repair, which can effectively improve the chewing ability and the gingival condition, the incidence of adverse reactions is low.