Objective To compare the effects of resin cosmetic restoration and crown fragment reattachment on aesthetic satisfaction in patients with traumatic dental injuries in young permanent teeth. Methods A total of 80 patients with traumatic dental injuries in young permanent teeth admitted to Changshu Yuhui Dental Hospital from July 2024 to July 2025 were selected, and they were divided into group A and group B according to different restoration methods, with 40 patients in each group. Group A was treated with resin cosmetic restoration, and group B was treated with crown fragment reattachment. The restoration success rate, aesthetic satisfaction and restoration effect were compared between the two groups. Results There were no statistically signiffcant differences in the restoration success rate between the two groups at 1 and 3 months after restoration (P>0.05). The satisfaction scores of group B in color, chewing, adaptability, comfort and aesthetics were higher than those of group A (P<0.05). The scores of restoration retention, marginal integrity and marginal staining in group B were higher than those in group A (P<0.05). There were no statistically signiffcant differences in the scores of secondary caries and periodontal status between the two groups (P>0.05). Conclusion Both resin cosmetic restoration and crown fragment reattachment can achieve a high restoration success rate in patients with traumatic dental injuries in young permanent teeth, but crown fragment reattachment has more advantages in improving patients' aesthetic satisfaction, and has better effects in restoration retention, marginal integrity and marginal staining control.