Objective To explore the effect of dental implant restoration on masticatory efficiency and aesthetics of restored teeth in patients with distal extension edentulism. Methods A total of 86 patients with distal extension edentulism admitted to Cixian People's Hospital from March 2024 to March 2025 were selected as the research subjects, and they were divided into the control group and the observation group by the random number table method, with 43 patients in each group. The control group was treated with removable denture restoration, and the observation group was treated with dental implan t restoration. The masticatory efficiency, alveolar bone resorption, restoration effect and aesthetics of restored teeth were compared between the two groups. Results The masticatory efficiency of the observation group after restoration was better than that of the control group (P <0.05). The alveolar bone resorption of the observation group at 3 and 6 months after restoration was smaller than that of the control group (P <0.05). The total effective rate of the observation group (97.67%) was higher than that of the control group (81.40%) (P <0.05). The aesthetic score of restored teeth in the observation group after restoration was higher than that in the control group (P <0.05). Conclusion The application of dental implant restoration in patients with distal extension edentulism can help to improve masticatory efficiency, reduce alveolar bone resorption, enhance the aesthetics of restored teeth, and achieve a good restoration effect.