OBJECTIVE To evaluate clinically the long-term (7-year) behavior of resin-based composite restorations and original fragment reattachments. METHODS From an initial number of 130 young subjects (8-18 years old), only 60 fulfilled the inclusion criteria and consented to the evaluation of long-term follow-up of their restorations. Out of a total of 90 injured teeth, 70 were treated with direct composite restorations, and 20 with the original fragment reattachment technique. These 90 teeth were divided according to traditional (Andreasen, Ellis) classifications and according to a new classification (Spinas-Piroddi). Then the restorations were examined according to a modified version of USPHS method during the 7-year follow-up. RESULTS Three-year old composite restorations needed some kind of treatment (ranging from polishing to the replacement of the restoration); in the period between 3-5 years, all the restorations (belonging to all of the injury types) needed a complete replacement. The results indicated that a restoration can probably be replaced three or four times before the tooth shows severe reduction of its adhesive properties. Composites cannot be used for long-term restorations; if the subject has completed his growth, the mandatory therapeutic alternatives are prosthetic restorations (crowns, porcelain veneers).