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Aluminum stimulates the proliferation and differentiation of osteoblasts in vitro by a mechanism that is different from fluoride.

Acknowledgements This work was supported in part by research grants from the Arthritis Foundation, the Southern California Chapter, and the National Institute of Dental Research (ROl DE08681). The authors wish to thank Mr. Noah Awoniyi for his technical assistance, and the Medical Media staff of the Jerry L. Pettis Memorial Veterans' Hospital for their assistance in the preparation of the manuscript. References Ward MK, Feest TG, Ellis HA, Parkinson IS, Kerr DNS: Osteomalacic d

Water fluoridation and hip fracture

In a recent article in THE JOURNAL, Jacobsen et al (1) demonstrated a positive ecologic association between hip fracture discharge rates in the United States and fluoride content in water supplies. In a similar study, we recently reported the ecological association of discharge rates for hip fracture and water fluoride levels in 39 county districts in England. (2) Our study was performed in response to the suggestion that fluoridation of water might serve to stem the rising tide of hip fracture