Objective To explore the application effect of digital smile design based on facial aesthetic coordination concept combined with digital BOPT guide plate technology in aesthetic restoration of maxillary anterior teeth. Methods A total of 50 patients undergoing aesthetic restoration of maxillary anterior teeth who visited the Department of Stomatology of our hospital from January 2022 to June 2023 were selected, and they were divided into the control group (n=25) and the experimental group (n=25) by the random number table method. The control group adopted traditional diagnostic wax pattern and conventional shoulder preparation technology, and the experimental group adopted digital smile design based on facial aesthetic coordination concept combined with digital BOPT guide plate technology. The satisfaction, restoration marginal adaptation, periodontal health status, diagnosis and treatment-related indicators and restoration USPHS grade were compared between the two groups. Results The satisfaction scores of aesthetic effect, comfort, masticatory function and total satisfaction score of the experimental group were higher than those of the control group (P<0.05). The BOP positive rate of the experimental group was lower than that of the control group, and the marginal adaptation, total diagnosis and treatment cycle, and doctor-patient communication times were lower than those of the control group (P<0.05). The proportion of grade A of USPHS restoration evaluation in the experimental group (100.00%) was higher than that in the control group (72.00%) (P<0.05). Conclusion The digital smile design based on facial aesthetic coordination concept combined with digital BOPT guide plate technology is a precise, predictable and efffcient method for aesthetic restoration of maxillary anterior teeth. It can improve the restoration effect, patient satisfaction and diagnosis and treatment efffciency, and create favorable conditions for establishing a healthy restoration-periodontal interface.