BACKGROUND: Dental esthetics has become an important discipline in dentistry as patients have started requesting highly esthetic restorations on upper front teeth. Therefore, dentists must be prepared to meet the esthetic demands and high expectations of their patients. Clinical and patient's assessments of quality may differ. PURPOSE:The purpose of this study is to assess and compare clinical assessment and patient's evaluation of direct and indirect esthetic restorations of upper front teeth. MATERIALS AND METHODS: Two hundred subjects evaluated color, anatomical shape and surface texture of maxillary anterior teeth restorations (composite fillings, acrylic faceted metal crowns, porcelain-fused-to-metal crowns and all-ceramic crowns) in comparison to adjacent natural teeth ranking the appearance as good, satisfactory or poor. Patients also assessed general impression of their maxillary anterior teeth restorations and rated it as satisfactory or unsatisfactory. Results were compared with clinitian's assessment. The data were expressed in average assessment scores for color, anatomical shape and surface texture as well as overall average assessment scores for every type of restoration and overall average assessment scores for color, anatomical shape and surface texture of all the restorations in general. Logistic regression analysis was used to determine factors that influenced the patient's satisfactory or unsatisfactory overall impression for restorations on the upper front teeth. RESULTS: All-ceramic crowns were evaluated as best match with the tested natural tooth and the composite fillings as worst. Colour of the restoration is a characteristic where the participants were the stricktest in evaluation. Women were much stricter in assessing esthetic restorations on the upper front teeth (p <0.05). In assessing aesthetic parameters of composite fillings, faceted acrylic and metal-ceramic crowns older patients were strickter than younger respondents(p> 0.05). Younger patients were more satisfied with their restorations than older subjects in general (p <0.05). General impression of restorations was better if the patient positively assessed composite fillings (p <0.059). Dentists's assessment of aesthetic parameters of upper front teeth restorations was always strickter than the patients one (p <0.05). CONCLUSION: Restoration type can affect patient's satisfaction by its aesthetic and technical characteristics, and not the tested aesthetic parameters. Aesthetic evaluation of restorations and general impression of dental aesthetics is a combination of objective parameters and subjective impression. There is no universal formula for getting a perfect appearance of oral cavity. Therefore a dentist must follow some general guidelines and adapt them to patient's wishes and of course, ultimately, blend his/her aesthetic restoration with patient's facial physiognomy.