This case report describes the nonsurgical creation of an interdental papilla in orthodontic therapy of a patient with severe periodontal disease. A large diastema between the maxillary incisors was closed completely, and the lost interdental papilla was re-created by orthodontic therapy after nonsurgical periodontal therapy. Radiographs showed improvement of the bone defect. Periodontal/orthodontic soft tissue manipulation is a nonsurgical technique that can lead to reformation of the interdental papilla, provided that periodontal health is maintained. Keywords: children, dental caries, infants, lesion severity, microbial acid production