Obtaining the size of the maxillary anterior teeth when performing an esthetic smile rehabilitation can be a difficult task. Metrics based on dental proportions to assist in the process are required. This study aimed to evaluate the lower facial third proportions i.e., the interalar, interphiltral, and intercommisural distance with dental proportions in predicting maxillary anterior teeth width in Pakistani citizens. This analytical study was conducted on 230 participants. Front face and retracted smile photographs were captured for all the participants, followed by maxillary impression making. The cast was then converted to 3D models for analysis. The data were entered into SPSS-25. Descriptive statistics were carried out for frequency, mean, standard deviation, and percentage calculation of gender, teeth widths, horizontal mid facial proportions, and age of the participants. Independent t-test was applied for analysis of gender and arch side disparity. Regression analyses were performed to analyze the relationship between independent variables (gender, age, weight, and height) and dependent variables (horizontal facial proportion, dental proportion). A p-value of ≤0.05 was considered statistically significant. The interphiltral distance (IPLD) modified with Preston proportion (PRP) showed no significant difference with combined central incisor width, whereas a significant difference was found with golden proportion (GP), 70% recurrent esthetic dental (RED) proportion, and golden percentage (GM) modification. However, the interalar (IAD) and intercommisural distance (ICoD) modified with dental proportions showed a significant difference with maxillary anterior teeth width. The width of maxillary anterior teeth determined by plaster dental cast and 3D dental cast showed no significant difference. The ICoD, IAD, and IPLD could not be used to determine combined central incisor and intercanine width directly. The interphiltral distance modified with Preston proportion is a reliable method to predict combined central incisor width in the population studied. There was a significant difference in gender disparity when ICD, IAD, and IPLD were modified with dental proportions, except in the case of IPLD by the Preston proportion group. The golden proportion, 70% RED proportion, and golden percentage by lower facial third facial proportions are not reliable methods to predict maxillary anterior teeth width. View Full-Text