Orthodontic approximation has been proposed as a tool for restoring the lost papilla. A prospective analysis was performed to evaluate the changes in the levels of interdental papilla and alveolar crest following an orthodontic approximation. The levels of interdental papilla and alveolar crest increased; however, the interradicular distance did not influence the level of the interdental papilla or papilla score. Interestingly, the shape of the teeth had a significant impact on the interdental papilla score. In conclusion, orthodontic approximation significantly enhanced the level of the interdental papilla and interproximal alveolar crest, producing an improved esthetic outcome. (Int J Periodontics Restorative Dent 2014;34:219-224. doi: 10.11607/prd.1852)