The reconstruction of the peri implant papilla presents one of the greatest challenges in implant dentistry. Hopeless teeth are often characterized by interproximal clinical attachment loss at the adjacent dentition, which inevitably increases the complexity of implant therapy, especially in the esthetic zone. Without proper management of the hard and soft tissue components after the extraction of hopeless dentition, dental implants often have suboptimal esthetic outcomes. These outcomes can be related to the midfacial level of the peri-implant soft tissue margin alone, or also to the interproximal soft tissue. Implants with deficient papillae and black triangle are common findings. It should be noted that both clinicians’ and patients’ standards for dental implants have significantly increased in the last decade. Even a small deficiency of a peri-implant papilla in the anterior region can be considered a compromised clinical outcome. This presentation will focus on ridge augmentation using Guided bone regeneration in difficult clinical scenarios when patients presenting with a lack of the interproximal bony peak. The utilization of biomaterials, membranes and growth factors such as ABBM, perforated d-PTFE in combination with collagen membranes and growth factors such EMD, PDGF-BB, BMP-2 for the combination of vertical ridge augmentation and interproximal bone reconstruction will be discussed in details. Subsequent soft tissue augmentation for inter-implant papilla reconstruction using the Iceberg and Garage connective tissue graft techniques will be introduced. These techniques are also applied to enhance inter implant papilla height after vertical ridge augmentation. Long-term follow-up utilizing these techniques will be presented.