Contemporary literature agrees that orthodontic results can no longer be limited to occluso-functional success. The integration of the teeth into a healthy periodontium is essential to good treatment finish and durability.This article proposes to describe the orthodontic physiopathological and iatrogenic lesions leading to the opening of black triangles in place of the inter-dental papillae. It goes on to discuss different periodontal, prosthetic as well as orthodontic reconstruction protocols.This last point, supported by a biological rationale well-known to periodontologists, is described using clinical cases.