Objective: To investigate the effects of different implant restoration strategies on occlusal contact distribution in the posterior region, as well as patients’ subjective masticatory comfort and aesthetic perception. Methods: A total of 120 patients with posterior tooth loss who underwent implant restoration in our hospital from January 2023 to January 2026 were selected and randomly divided into a control group and an observation group (60 cases each) using a random number table method. The control group received conventional implant-supported fixed restoration, while the observation group received optimized implant restoration. The occlusal contact distribution after restoration, masticatory comfort, and aesthetic perception were compared between the two groups. Postoperative complications were also recorded and compared. Results: After restoration, the observation group showed a more uniform occlusal contact distribution, with a greater number of contact points and larger contact area than the control group (P<0.05). The masticatory comfort score in the observation group was higher than that in the control group (P<0.05). The aesthetic perception score in the observation group was also higher than that in the control group (P<0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Compared with the conventional implant restoration strategy, the optimized implant restoration strategy can significantly improve occlusal contact distribution in the posterior region, enhance patients’ masticatory comfort and aesthetic satisfaction, and demonstrates good overall safety, indicating high clinical application value.