Bone is a living, dynamic, vascular, mineralized, connective tissue, characterized by its hardness, resistance and ability to remodel and repair itself. It provides structural support and protection for the bone and vital organs and it serves as a mineral (calcium) and blood cell reservoir for the body. Bone loss and skeletal deficiencies due to traumatic injury, abnormal development, or cancer are major problems worldwide, frequently requiring surgical intervention. Current treatments have achieved a level of success, but still have limitations. Researchers have begun to enhance current treatments and develop novel bone grafts from biological or synthetic materials. These options include the use of biocompatible polymers to mimic trabecular and cortical bone, hormones or growth factors, and bioactive ceramic glass. This patent review presents backgrounds on bone biology and structure, current treatments for damaged bone and bone defects, and new bone grafting technologies in hopes of creating an optimal bone graft substitute.