Adolescence is defined as a population ranging from ten to nineteen years old. Permanent teeth in adolescents are of critical significance as they are actively involved in mastication, contribute to aesthetic appearance, play a role in pronunciation, and are integral to the growth and development of the stomatognathic system. Specifically, permanent teeth in adolescents comprise those with incomplete root development and those with complete root development but unstable gingival margin positions. However, the prevalence of permanent tooth defects among adolescents remains high, primarily due to their insufficient awareness of oral health care and poor compliance with preventive measures. Therefore, it is very important to emphasize the necessity for timely and appropriate restoration of permanent tooth defects in adolescents. Given the distinct physiological characteristics of adolescent permanent teeth compared with mature permanent teeth, interim restoration approaches are required. The field of adolescent permanent tooth restoration is an interdisciplinary area, involving both prosthodontics and pediatric dentistry. Currently, a comprehensive and standardized principle for the selection of restoration indications is lacking, which poses challenges for clinicians in making optimal treatment decisions. Therefore, this article aims to comprehensively summarize the clinical dilemmas associated with the restoration of adolescent permanent teeth, and propose a set of principles for the selection of restoration methods and materials, aiming to offer practical clinical guidelines for dentists when dealing with permanent tooth defects in adolescent patients. In particular, because of the different restoration dilemmas of anterior and posterior permanent teeth, a variety of interim restoration methods, their applicable conditions, advantages, and disadvantages are introduced respectively. Additionally, it provides an in-depth discussion of different interim restoration materials, including direct restoration materials like light-cured composite resin and dual-cured temporary crown resin, as well as indirect restoration materials such as polymeric porcelain and CAD/CAM resin-matrix ceramics. The goal of this research is to provide a foundation for the development of evidence-based restoration plans in clinical practice and to contribute to the establishment of future standards in the field of adolescent permanent tooth restoration. This will enhance the quality of dental care for adolescents and promote better oral health outcomes in this population.