[Assessment of bone quality. Bone remodeling and bone quality].

Bone remodeling is a sequential process consisting of osteoclastic bone resorption and osteoblastic bone formation. Excess bone remodeling reduces bone mass, while suppressed bone remodeling increases it. Bisphosphonate treatment increases bone mass in patients with osteoporosis. However, bone strength is determined not only by mass but also by bone quality, and suppressed bone remodeling may reduce bone quality due to accumulation of micro fractures and to other mechanisms. Therefore understanding the relationship between bone remodeling and bone quality is essential to design interventions to effectively treat osteoporosis.