This article subscribes to the initial condition of bone quality and its ultimate effect on the success of dental implant treatment. A high success rate for the preservation of the alveolar bone around oral implants is predicated on good bone quality. For implantologists, the classification of bone quality should be based on the key elements required for osseointegration. These include structural morphology and cellular characteristics such as monocytes/ macrophages, mesenchymal progenitor cells, fibroblasts, osteoclasts, and cells associated with angiogenesis. © 2009 Lippincott Williams & Wilkins.