Background: Microesthetics in orthodontics, which focuses on subtly and precisely enhancing a patient's smile's esthetics, has seen a rise in popularity in recent years. The objective of this systematic study was to assess our present understanding of orthodontic microesthetics.

Methods: A thorough search was done using the terms "microesthetics in orthodontics," "aesthetic orthodontics," "orthodontic aesthetics," and "orthodontic smile design" across different databases. Articles published between 2011 and 2022 were considered for selection in this review.

Results: Five studies were selected for the review. The meta-analysis found a statistically significant and clinically relevant improvement in microesthetic parameters due to orthodontic treatment. The odds ratio estimate was 0.32 (95% confidence interval (95% CI): 0.28 to 0.37), suggesting a noticeable effect of orthodontic treatment on microesthetic parameters. The forest plot also showed an overall risk ratio of 0.57 (95% CI: 0.53 to 0.61) and a risk difference of -0.28 (95% CI: -0.31 to -0.24) for noticeable versus negligible effects of orthodontic treatment on microesthetic parameter in patients. The heterogeneity was significant among the studies, with a Chi-square value of 15.34 (P = 0.004) and 14.79 (P = 0.005) for the odds ratio and risk difference, respectively, indicating a moderate level of heterogeneity.

Conclusion: The results of this study's review and meta-analysis point to a statistically significant and clinically meaningful difference in the microesthetic parameters between individuals who received orthodontic treatment and those who did not. The heterogeneity statistics, however, indicates significant variation between research studies.

Registration: This review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42022397219).