**3.6 Nonspecific conditioned enlargement**

Pyogenic granuloma: it is a tumor-like enlargement of gingiva which is considered to be exaggerated conditioned response to minor trauma. The exact nature of the systemic conditioning factor has not been identified [23]. The lesion varies from a discrete spherical, tumor-like mass with a pedunculated attachment to a flattened, keloid-like enlargement with a broad base. It is bright red or purple and either friable or firm, depending on its duration; in the majority of cases it presents with surface ulceration and purulent exudation (**Figure 8**). The lesion tends to involute spontaneously to become a fibroepithelial papilloma, or it may persist relatively unchanged for years [6].
