Modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. The loss of interproximal dental papillae may cause functional, phonetic, and devastating esthetic problems. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. On reviewing the literature, publications involving surgical and nonsurgical techniques for papilla reconstruction are basically case presentations. Very little scientific data concerning long-term success and predictability of specific techniques has been published so far. Starting with facts about the anatomy and morphology of the interdental tissues, this article gives an overview of surgical and nonsurgical techniques to restore lost interproximal dental papillae.