Objective To investigate the aesthetic effect of digital smile design (DSD) in the treatment of anterior porcelain veneer restoration. Methods From February 2022 to February 2024, 58 patients who received oral medical cosmetology treatment in our hospital were selected as the research objects. They were divided into conventional group and experimental group by random number table method, with 29 patients in each group. The conventional group was treated with traditional all-ceramic restoration, and the experimental group was treated with DSD all-ceramic restoration. The aesthetic effect, periodontal health status, implant integrity rate and complication rate were compared between the two groups. Results The appearance, color matching degree and comfort score of the experimental group were higher than those of the conventional group (P <0.05). After treatment, PD, BI and AL in the experimental group were better than those in the conventional group (P <0.05). The implant integrity rate of the experimental group was higher than that of the conventional group at 3 and 6 months after restoration (P <0.05). The incidence of complications in the experimental group (6.90%) was lower than that in the conventional group (17.24%) (P <0.05). Conclusion DSD is effective in the restoration of anterior teeth porcelain veneer, which can effectively improve the periodontal health status of patients. Meanwhile, the integrity rate of the restoration is relatively high, which can effectively reduce the risk of complications and is worthy of application.