Reconstructive surgical techniques have significantly evolved during the last 30 years, but saving the compromised teeth by applying established principles is still the primary goal. Success of reconstructive surgery is highly correlated with wound stability in the early and late phases. Biomaterial exposure or healing by secondary intention may lead to bacterial contamination in the surgical area and impair the outcomes of periodontal regeneration particularly in the interproximal site. To date, different surgical procedures have been proposed to preserve the interdental papilla during the early and late phases of wound healing to prevent contamination of the regenerating area and eventual wound failure. However, published findings do not report 100% primary closure over the defect-associated papilla during the wound healing process. An ideal flap design may overcome this particular issue and preserve the original anatomy of the entire interdental soft tissues. In the current presentation, critical elements and new perspectives of the regenerative periodontal surgery will be discussed.