Abstract
INTRODUCTION: Aesthetic outcomes are increasingly vital in dental care, especially in achieving harmony between facial and dental features. Traditional smile design methods rely heavily on clinician judgment, which introduces subjectivity and variability. Digital Smile Design (DSD) offers an eco-friendly and standardized alternative, promoting improved aesthetic outcomes with reduced environmental impact. This systematic review aims to synthesize current evidence regarding the effectiveness and sustainability of DSD in enhancing dental aesthetics and patient satisfaction compared to conventional approaches. METHODS: A systematic review was conducted following PRISMA guidelines. Articles were retrieved from PubMed, Scopus, EBSCO, and ScienceDirect using pre-defined keywords and MeSH terms. Eligible studies included randomized controlled trials and experimental studies published between 2019 and 2024. This review synthesizes evidence regarding the clinical effectiveness and eco-friendly implications of Digital Smile Design (DSD) compared to conventional smile planning, focusing on aesthetic outcomes, patient satisfaction, and environmental sustainability. Quality assessment was performed using the Joanna Briggs Institute (JBI) critical appraisal tools. RESULTS: Twelve studies met the inclusion criteria. Overall, DSD consistently improved smile aesthetics through enhanced alignment, tooth shape harmony, and lip symmetry. Patient satisfaction was also generally higher with DSD due to its precision, reduced chair time, and less invasive procedures. Many studies also emphasized the eco-friendly benefits of DSD, such as minimized material waste and reduced need for multiple visits. CONCLUSION: DSD is an effective and sustainable approach for enhancing dental aesthetics and patient experience. Its adoption in clinical practice may support a shift toward more precise, patient-centered, and environmentally conscious dentistry. However, variations in study design and reporting highlight the need for further standardized research.