Digital Smile Design and Patient-Centered Outcomes in Esthetic Restorative Dentistry: A Systematic Review

Digital Smile Design (DSD) has become an increasingly valuable tool in esthetic restorative dentistry, offering digital visualization, improved communication, and enhanced precision during treatment planning. This systematic review evaluated the influence of DSD on patient-centered outcomes, including satisfaction, esthetic perception, quality of life, and psychosocial impact. A comprehensive search of PubMed/MEDLINE, ScienceDirect, Google Scholar, and the Cochrane Library was performed from inception to August 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were eligible if they assessed DSD within esthetic restorative procedures and reported patient-centered outcomes. Seven studies met the inclusion criteria, encompassing randomized controlled trials, observational studies, and qualitative analyses from diverse clinical settings. Sample sizes ranged from small qualitative cohorts to large randomized trials. Across all included studies, DSD consistently improved patient satisfaction, treatment acceptance, communication, and perceived predictability compared with conventional approaches. Quantitative evidence demonstrated significantly higher satisfaction scores and superior esthetic and functional ratings in DSD-guided treatments. Studies with follow-up data also reported stable long-term outcomes and improved self-confidence among patients. Despite these promising results, the evidence base remains limited by heterogeneity in study designs, varied outcome measures, and small sample sizes in some studies. Overall, DSD appears to enhance patient-centered outcomes in esthetic restorative dentistry, but further high-quality, longitudinal research is needed to validate its long-term clinical and psychosocial benefits.