Divine Proportions in the Assessment of Facial Esthetics—Antiquity vs Contemporary: A Systematic Review

Objective: The objective of this research was to systematically evaluate evidence regarding the correlation between divine proportions and facial esthetics. Materials and Methods: An extensive literature search was performed in multiple electronic databases such as PubMed, Medline, Embase, ScienceDirect, and ProQuest which included articles published from May 1982 to March 2021 in the English language. Furthermore, only randomized clinical trials and original research studies were included. The risk of bias in the included studies was assessed by using the Cochrane risk-of-bias tool ROBVIS (Risk-of-bias VISualization tool). Results: A total of 2,736 articles were retrieved and 974 duplicate records were eliminated; subsequently, articles were screened based on title and abstracts, inclusion and exclusion criteria from which a total of 14 original articles were included in the systematic review. Of the 14 included studies, 5 studies showed a low risk of bias, 6 studies showed a moderate risk of bias, and 3 showed a high risk of bias. Four studies showed a positive correlation and 10 studies showed a negative correlation between divine proportions and facial esthetics. Conclusion: The evidence from this study suggests that there exists a weak correlation between divine proportions and facial esthetics. Hence, divine proportions are not absolute determinants and are only partially related to facial attractiveness. Further high-quality cross-sectional studies with a strong methodology are needed to establish the correlation between divine proportions and facial esthetics and to support this evidence. Trial registration number: PROSPERO CRD42022302308