Ladies and gentlemen, welcome to the Straumann Group Q2 2021 results conference call and live webcast. I'm Moira, the Carrolls call operator. I would like to remind you that all participants will be in listen-only mode and the conference has been recorded. The presentation will be followed by a Q&A session. You can register for questions at any time by pressing star and one on your telephone. For operator assistance, please press star and zero. The conference must not be recorded for publication or broadcast. At this time, it's my pleasure to hand over to Guillaume Daniellot, CEO. Please go ahead, sir.
Thank you and good morning, everyone. Thank you for joining this conference call about Straumann Group's first half-year results for 2021. I very much hope that you, your families, and your colleagues are doing well. Although the restrictions are being lifted in many countries, the numbers of COVID-19 cases remain high and are rising again in many areas. We are put forward in many places. As a company, we strongly support vaccination as we believe that it is the only way out of the current situation. Please take note of the disclaimer in our press release and on slide two. During this conference, we are going to refer to the presentation slides that were published on our website this morning. As usual, the presentation and discussion will include some forward-looking statements.
The conference will follow the usual format as shown on the agenda on slide three, and I will give you an overview of where we stand. Then our CFO, Peter Hackel, will share details about the business performance across our regions. After that, I'll provide you with an update on key strategic initiatives and our outlook for the future. Of course, we'll both be available to answer your questions at the end of the presentation. Let's start with our highlights and move directly to slide five. Please keep in mind that pandemic-related disruptions significantly impacted our second quarter 2020 results, and this should be considered when making comparisons to our second quarter 2021 results. Straumann Group revenue reached CHF 986 million in the first six months of 2021. This was driven by continued growth in the second quarter, with revenue of CHF 516 million.
This result was only possible because our entire team did a tremendous job of focusing on customer needs and delivering on the high level of demand. Organic sales increased by 63% in the first half of the year and by 103% in the second quarter. Profitability significantly improved, and we achieved a core EBIT margin of 28.8%. Straumann Group continued to invest in innovative technologies, go-to-market opportunities, and production capacity expansion. Our immediate portfolio definitely continues to be a highlight, and our innovative fully tapered BLX implant system is further growing its positions in the immediate market. To support our continued market share gains, the new TLX implant, which we have already successfully pre-launched, will be fully launched in the third quarter of this year. On the clear alignment front, we strengthened our doctor-led direct-to-consumer business by acquiring the Brazilian company Smiling.
Similar to Doctor Smile, Smiling combines direct-to-consumer marketing expertise with high-quality doctor-led treatment, further complementing Straumann's existing clear aligner business. Given the strong first half of 2021, we have raised our guidance to full-year organic revenue growth of above 30%, and we expect profitability to nearly reach the 2019 level, assuming the pandemic does not negatively impact the patient flow. On slide six, you can see our strong growth continues in all regions in the second quarter of 2021. It is important to keep in mind that the comparison quarter in 2021 was heavily impacted by the pandemic, and overall, the patient flow remained healthy around the world, and the tailwind for specialty dental treatments that already supported the first quarter continued.
We expect this tailwind to continuously soften during the second half of the year, even though our customers are currently reporting that their appointment calendars are solidly booked. EMEA and North America are reporting organic growth increases of 102% and 135%, respectively. Latin America and Asia Pacific performed also strongly, with 164% and 63% growth, respectively. In Asia Pacific, the recovery began in the second quarter of last year, so the comparative base for this year's growth rate is higher than for the other regions. Overall, this leads to a very solid two-year average growth rate of 16% for the group. With this, I will hand over to Peter to provide you additional details.
Thank you, Guillaume, and good morning, everyone. I would like to start by talking about our revenue and operating profit on slide eight. As Guillaume mentioned, the group's revenue reached CHF 986 million in the first six months of 2021, which is a record for the first half of the year. This is in contrast to the first half of 2020, when revenue decreased by 22% to CHF 605 million because of lockdowns. This result was supported by the strong performance of our existing portfolio, and as Guillaume mentioned, thanks to the healthy patient flows around the world, as well as the ongoing tailwind for specialty dental treatments.
The second quarter revenue reached CHF 516 million in 2021, with a corresponding growth of 108% compared to CHF 248 million in the second quarter of 2020, when revenue dropped almost 40% in Swiss francs due to the pandemic. To put this into perspective, in the second quarter of 2019, revenue rose by 14% in Swiss francs to CHF 408 million. Looking at slide nine, you can see more details about the revenue development. At 2021 exchange rates, our 2020 first half revenue would have been CHF 15 million lower because of unfavorable currency effects that were mostly related to the depreciation of the U.S. dollar, the Turkish lira, and the Japanese yen. The favorable development of the euro only partially offset this negative currency effect. However, as you might remember, in previous years, currency headwinds were considerably higher.
The M&A effect this year added CHF 14 million to our adjusted revenue of CHF 604 million. This was largely related to Doctor Smile. In the middle of the chart, you can see that all of our regions reported double-digit growth in the first half of 2021. The absolute organic growth of CHF 381 million was mainly driven by EMEA and North America, which are our biggest regions. Let's move on to slide 10 and have a closer look at the regions. EMEA and North America contributed CHF 230 million and CHF 152 million to group revenue. Given last year's low base, they reported triple-digit organic growth of 102% and 135%, respectively. The EMEA region remained the group's largest revenue contributor. Premium implants are picking up fast, with strong sales across the entire premium immediacy portfolio.
The challenger implant brands are also performing well, with Neodent now established as a brand in the region. The orthodontics business is strongly supporting growth in EMEA with Doctor Smile and ClearCorrect, which recently launched its Clear Quartz material. Overall, growth in this region was driven by Germany, Liberia, Russia, and the U.K. North America only began to recover at the beginning of June last year when lockdowns started to ease. This led to an organic decline of 42% in the second quarter of 2020. In the second quarter of 2021, the North America region returned to strong growth thanks to the implant business, which is being driven by the Straumann and Neodent brands. Some large wins with dental service organizations in the first half of the year propelled the business to higher growth rates.
Digital solutions are growing very quickly, and the orthodontics business was supported by the recent software improvements. Overall, our Canadian business, which is significantly smaller than the U.S. business, is growing almost twice as quickly as the U.S. due to the continuous penetration, increase of the Challenger brands, and digital solutions. Slide 11 focuses on our performance in the Latin America and Asia Pacific regions. Asia Pacific saw organic revenue increase to CHF 103 million in the second quarter, which is a 63% increase compared to the same period in 2020 when most countries in the region started to rebound in June. From the first to the second quarter of 2021, our business accelerated throughout the region by growing the existing business and increasing market share led by China, Japan, and Taiwan. Premium and Challenger implant brands are driving growth, while Challenger brands are growing faster than premium brands.
Latin America reported revenue of CHF 31 million in the second quarter of 2021 and grew 164% organically. This is a significant improvement compared to the same quarter of 2020, when we reported a decline of 60% to CHF 11 million in revenue. Brazil is by far the biggest revenue contributor in this region and managed to continue the strong growth performance seen in the first quarter of 2021. This was followed by strong growth in Argentina and in Chile. Neodent continues to be the strongest brand in the region, while the premium implant brand is establishing its position further. Digital solutions are growing very well, with the Virtuo Vivo intraoral scanner gaining momentum. The orthodontics business is increasingly contributing to the regional performance, and the acquisition of Smiling will help to further establish the group's doctor-led direct-to-consumer portfolio.
The two regions, Latin and Asia Pacific, contributed CHF 134 million to overall group revenue. Turning to slide 12, we can take a look at our performance by business. Implant sales more than doubled and once again contributed the largest share of our growth. The group's premium immediacy solutions continue to be an important growth driver. You will hear more about this exciting development from Guillaume later. Our Challenger implant franchise outpaced the premium business again. We almost doubled sales of Neodent in North America, while Ontogear showed fast growth in Asia and almost doubled its European business compared to 2020. Our digital and restorative business saw high double-digit growth, with a particularly impressive contribution from North America. The trend for digital is continuing and supports our intraoral scanner sales. Our biomaterials business has rebounded and sales more than doubled, which was driven by all regions.
Sales in orthodontics almost tripled in the second quarter. This was driven by the new material Clear Quartz, the updated software ClearPilot 2.0, and further software enhancements fueled by high demand for doctor-led direct-to-consumer Clear alignment solutions. The next slide shows an overview of our core financials. Core gross profit rose to CHF 752 million and core EBIT rose to CHF 284 million, with the respective margins reaching 76% and 29% in the first half of 2021. The gross margin improved by 530 basis points, while the EBIT margin gained 1,220 basis points. The respective currency headwinds took 30 basis points off the gross as well as the EBIT margin. Core net profit increased by more than 200% to reach CHF 227 million, and the margin improved by 1,090 basis points to just above 23%. As a result, basic earnings per share increased from CHF 4.49 to CHF 14.19.
For full clarity, you will find the year-on-year comparison on a reported IFRS basis on slide 14, followed by the alternative performance measures reconciliation table on slide 15. Our reported net profit rose to CHF 175 million. The increased estimate of contingent consideration payable due to the very strong sales performance of Doctor Smile represents the majority of the difference related to core net profit. As per definition, amortization of acquired intangibles are excluded from the core net profit. Looking at gross profit development on slide 16, our gross margin for both core and reported amounted to 76% in the first half of 2021. This improvement was mainly due to top-line leverage and efficiency gains, which added 560 basis points and brought our margin close to the level achieved in 2019.
As a consequence of our strategy, the more dynamic growth in digital and value implants caused a change in our portfolio mix, which led to a decrease of 110 basis points. Without the currency headwind, our margin would have increased by 30 basis points. As shown on slide 17, our core EBIT margin expanded by 12.5 percentage points to 28.8%. This was mainly due to the operational gearing and lower OpEx expenses in distribution and administration because of fewer onsite activities such as customer and education events, as well as related business travel. Unfavorable currency movements cut the improvement of the margin by 0.3 percentage points. As you can see on slide 18, the combination of the previously mentioned operational factors contributed CHF 154 million to core net profit, which tripled to CHF 227 million.
As described earlier, the increased estimate of contingent consideration payable to the sales of Doctor Smile led to reported net profit to CHF 175 million. Slide 19 provides a breakdown of our cash flow statement. The operating cash flow increased more than 400% to CHF 257 million, while the free cash flow increased from CHF 11.5 million to CHF 210 million. Income tax charges minus the delta in income tax payments increased by CHF 22 million. Changes in CapEx and networking capital were rather small. The half-year free cash flow margin increased to a historically high level of 21.3%. With a cash position of CHF 725 million, the group is CHF 217 million cash positive, considering all debts. I'll hand back to Guillaume.
Thank you very much, Peter. Let's move on to slide 21 and look at the recent achievements and strategic update.
To put everything into perspective, let's focus on the premium implant portfolio first. According to estimates, in 2020, the global dental implants market was worth about CHF 4 billion, with premium implants accounting for approximately half of the market in value terms. This market is divided into segments according to implant designs and the related treatment options. Parallel wall implants make up a quarter of premium implants and support a more traditional treatment approach. Tapered implants represent about half, while fully tapered implants represent about a quarter of the premium market. Tapered and fully tapered implants are designed for immediacy approaches that offer shorter time to seat or treatment options for health consumers. They also enable clinicians to reduce chair time per patient so they can treat more patients and grow their practices.
Worldwide, more than 80% of all implants and more than two-thirds of premium implants sold in 2020 were tapered. Our Straumann Premium brand entered this market segment in 2014 with the articulated tapered BLT, and we estimate that we have gained more than 40% market share in this segment since then. In 2019, the launch of BLX followed, which tapped into the fully tapered market segment. Another differentiating factor between implant designs is the level where the top of the implant is set in a patient's mouth, either at bone level or at tissue level. Our BL, BLT, and BLX implant lines are set to end at bone level. Our tissue level and the TLX implants, on the other hand, are designed to be placed with the micro gap at the tissue level, which offers advantages of simplicity for the prosthetic procedure.
With the Straumann TLX, we are bringing a unique solution to the market that combines the advantages of the fully tapered design for immediacy with the tissue level design for periodontal performance. This will continue to grow the fully tapered segment. Initially, customer surveys show that TLX can persuade clinicians who currently prefer traditional treatments to switch to immediacy treatment. TLX can also help us to win new customers who have used bone-level immediacy implants from our competitors and who appreciate the added value of the tissue-level concept. This brings us to slide 22, and immediacy is driving growth in the premium implant business. This continuing success confirms that these solutions also serve as an entry point for converting new customers and leveraging our entire product portfolio, including BLT.
In June 2021, roughly a quarter of BLX users were new Straumann customers, and more than two-thirds of them also purchased other Straumann implants, confirming the pull effect of BLX for our entire premium implant franchise. BLX is now available in 67 countries, and the global rollout is continuing. The most recent major launch was in Russia in June, making China the only remaining major market without BLX available. We are looking forward to bringing BLX to China in 2022. In addition, feedback shows that customers are seeing big potential for TLX to simplify the treatment of edentulous patients, while also benefiting from the predictability of the tissue-level design. For this reason, we expect TLX to drive growth for the edentulous segment. This was one of the key topics discussed at the TLX online symposium in June, which attracted almost 1,000 participants from 89 countries.
We also are on track for a full launch of TLX at the upcoming online ITI World Symposium in September, for which we have already received almost 4,000 registrations. On slide 23, you can see that the value market, which represents the other half of the CHF 4 billion implant dentistry market, also offers great potential. We estimate that we have a 10% market share in the value segment as we speak. About half of this is related to Neodent implants, which were sold in Brazil. All other regions still offer huge market potential, and our expansion in this segment worldwide is progressing very well. Slide 24 summarizes our position in the value segment. Our decision to enter the non-premium market in 2012 has significantly expanded our addressable market. Until then, Straumann was a premium brand only.
Our Neodent, MEDENTiKA, ONTOGEAR, and Nuvo brands now enable us to compete in the non-premium segment by offering implant systems at different price levels in different regions, as well as by offering attractively priced abutment or third-party systems. On top of this, our geographic footprint has grown. Neodent is now a global brand that is available in more than 80 countries. Consequently, we are continuously investing in ramping up our production activity. ONTOGEAR has also expanded its presence in key countries. This includes its home country, France, where ONTOGEAR is one of the top four players in the value segment. The brand is also expanding in Russia and China, and in fact, ONTOGEAR celebrates its 20th anniversary in China this year. Let's move to slide 25 and our orthodontic business, which continues to grow well.
The global market for clear aligners is one of the fastest-growing areas in dentistry, and we continue to expect growth in orthodontics and implant dentistry to outpace the general dental market. With the introduction of ClearQuartz, the new material of ClearCorrect aligners, we have made a huge step forward in further establishing our position in this segment by improving comfort for patients. In a recent survey we conducted, more than three-quarters of patients said that ClearQuartz aligners are more comfortable and have a better fit than aligners made from the previous material. More than half of the doctors stated that they will increase the number of cases they treat with ClearCorrect because of this new material. As mentioned previously, it was launched in Europe in the first quarter of 2021 and is now available in all markets except China.
Likewise, the new software Collaborator has been very well received in all markets. This new feature within the ClearCorrect digital customer portal that we launched at the beginning of this year supports collaboration on clear aligner patient cases by enabling doctors to share individual cases with staff, other clinicians, and treatment planning services. In this way, they are able to exchange expertise and seek advice. The global launch of the Clear Pilot 2.0 software update with additional features that improve visualization of treatment planning and enhance communication with patients has received excellent feedback. The update also includes a view that is optimized for mobile devices like tablet computers, which are widely used in many practices. With slide 26, I would like to speak about our direct-to-consumer brands for doctor-led clear aligner treatments.
Our Doctor Smile brand is expanding its network of partner practices in Europe, establishing its solution in Austria, France, Germany, and Spain, with recent rollout in the Netherlands and Sweden. Recently, we acquired Smiling in Brazil, which is one of the fastest-growing providers of orthodontic solutions in Latin America. Similar to Doctor Smile, Smiling combines direct-to-consumer marketing expertise with doctor-led treatment, and it complements Straumann's existing clear aligner business. This acquisition will offer further growth opportunities with partner dentists, and it strengthens the group's portfolio of convenient clinician-based aligner treatment solutions for patients. With this acquisition, we have now set the foundation to further establish orthodontics in the doctor-led direct-to-consumer segment in more markets around the globe. On slide 27, we can see the development of our workforce globally. Our global team did an amazing job to make this year's first-time results possible.
In particular, I would like to mention our colleagues in supply chain, production, and operations, who make sure we always have the raw materials we need and were able to meet high demand for our products despite the challenges of the global pandemic. We are constantly investing in people as part of our efforts to capture new growth opportunities and welcomed more than 800 new joiners to our global team in the first half of 2021. These colleagues are mostly employed in positions that support manufacturing of our Challenger and premium implants, as well as our orthodontics business and production. With slide 28, I would like to introduce Christian Ullrich, who will join Straumann Group's Executive Management Board as our new Chief Information Officer in October. Digital transformation is a key part of our growth strategy, and we have a critical impact on all our businesses, regions, and activities.
In his new role, Christian is going to drive and lead the acceleration of this transformation. Christian has an impressive track record in this field. He has successfully developed digital strategy and go-to-market models that are driven by platform approaches to increase product sales and create a positive experience for customers and health consumers. He also has outstanding leadership skills and will be a really great addition to our team. We are excited to welcome Christian to the Straumann Group and look forward to working together with him to shape our digital future. That brings us to slide 30, where I will share my thoughts about our outlook. As mentioned, standard practices were operating through the first half of 2021, and practice agendas are currently well booked. The ongoing growth in the second quarter was supported by the strong performance of our existing portfolio and the continuing tailwind.
Based on the assumption that this tailwind will become gradually softer on the one hand, and that the pandemic will not negatively impact the patient workflow during the second half of the year, on the other hand, we are raising our guidance to full-year organic revenue growth of above 30%, with the profitability nearly reaching the 2019 level. This outlook also reflects our continuous investment in future growth opportunities, our strong innovation pipeline, and our talented team that demonstrates its passion, resilience, and ability to outperform the market every day. Now, I would like to open the question and answer session. If you have a question, please press star and one on your phone to join the queue. As usual, we kindly ask you to limit the number of your questions to two in order to give other participants a chance to ask their questions within the available time.
Goes forward, can we have the first question, please?
Yes, sir. The first question is from Patrick Wood from Bank of America. Please go ahead.
Perfect. Thank you very much for taking my questions. Two, please. The first is on the aligner side of things. Obviously, very strong growth there. I'm just curious, how capacity constrained do you guys feel at this point within the aligner business, and what impact did that have on the second quarter? Also, within aligners, where do you think we're up to in terms of total malocclusion treatment now with your current system relative to brackets and wires? That's the first question. Second question, please. I'm just curious how you're thinking about the second half, and you've got a lot of puts and pulls.
You've got Delta moving through, but equally, at the same time, outpatient clinics, dental offices are probably likely to remain open, but then people need a holiday. I mean, there's a lot of pluses and minuses. Is that why you gave quite an open-ended guidance range on the top line, just because there's so many moving parts? How are you thinking about those aspects in general? Thank you.
Yeah, thanks a lot for the question. On the capacity constraint with regard to clear aligners, no, we did not face, fortunately, any constraint. We have been able to deliver in line with our customer expectations. It has been sometimes really close to maximum leveraging of our production capacity during that first half, but we have continued to expand our manufacturing capacity in the different sites that we are having.
As you know, we have now our manufacturing in Brazil, Curitiba, which is fully operational and working. We are currently continuing to expand our manufacturing in Europe, which is in Germany, and working very well, but keep expanding and doing CapEx investment. So far, so good, and our capacity in manufacturing is really supporting our very strong growth momentum. When it comes to our system on malocclusion coverage, I would say that we are still in the 60% range, that from simple to moderate. We are working hard to be able to develop our especially software capability to bring more of those complex cases. We believe that by 2022, we will once again increase very significantly this percentage with another version of our software.
Step by step, we'll be able to reach the specialist segment for which we are not really active there and focusing more on GBs due to those 60% coverage. This is a big part of our investment and future development for our clear aligner performance. When it comes to second half, yeah, I think we are still pretty positive about the second half. We have an open-ended guidance because we believe we can deliver double-digit growth in our second quarter and more so depending on the sanitary environment. We have done quite a good second half last year with 8% growth versus 2019. We had the pent-up demand, tailwind. We had really strong digital sales, and we believe that being already above double digits of the second half 2020 will be a good performance. If the tailwind continues, we may expect even better.
This is still very difficult to evaluate what would be the highest level of this open-end, as you said, because of the Delta variants, which are quite increasing in some regions and still seeing some low vaccination rate in some of the countries where the Delta variant is active. All in all, despite the plus and minus, we see the second half in a very confident manner, taking into consideration that the dentists we are discussing with are still their agenda solidly booked for the coming month.
Thank you for taking my questions.
The next question is from Michael Yuengling from Morgan Stanley. Please go ahead.
Thank you, and good morning. I'd like to ask two questions, please. Firstly, on the gross margin, for the first half, you showed this waterfall chart showing a negative mix effect of -1.1%.
Can you explain what is driving this, and what do you think this will look like over the next three years? Is this negative portfolio mix, perhaps from clear aligners and capital equipment, driving this progression on for the next couple of years? Secondly, on distribution cost to sales, where do you think this will pan out? Pre-COVID, you ran around 21% to sales. In the first half, on very strong numbers, you did 19%. Are we going to stay at 19%, or do we go back to 21%? Thank you.
Yeah, this is Peter speaking. Michael, thank you for your questions. On the first question, the impact of the negative product mix on the gross margin, I think if you compare first half 2021 with first half 2022, then we have obviously very different comparative periods, and we have a mixture of very different impacts.
I would not take that as a proxy to extrapolate the impact of the negative gross margin development over the next couple of years. I previously always commented I would expect a slight decrease in our gross margin due to that negative product mix in the order of 30 basis points. I think that is more a normalized figure than the one percentage point that we saw in the first half 2021. This is mainly driven by the digital equipment business in that period. On the second question with the distribution and sales expenses in relation to sales, I would see there not a significant change going forward compared to the pre-pandemic situation.
Please be aware that if you compare that also with the 2019 and with the 2020 level, in 2020 level, obviously, due to the lower sales performance, we also had a lower bonus payment cost in there, and that's always a significant part of our personnel cost in the distribution and sales pocket there.
Great. Maybe I can follow up on the sort of accounting. You changed your accounting some years ago with respect to how you disclosed certain financial items, including research and development. Can you just comment on whether R&D to sales for Straumann is going up or whether the ratio is going down?
No, the ratio on the R&D expense stays pretty stable over the last couple of years. Given the growth that we experience, obviously, the absolute amount of spending is increasing significantly.
Okay. Great. Thank you.
The next question is from Chris Grekler from Credit Suisse. Please go ahead. Mr. Grekler, your line is open.
Yes, thank you, Operator. Sorry, I was on mute. Good morning Guillaume Daniellot. Hope you're doing fine. Just wanted to come back on two things. First, this morning on Bloomberg, you were quoted saying that you're looking for potentially larger transactions. Maybe could you elaborate a bit more on kind of the areas in particular, and what does larger mean in the overall context of your company?
Yeah, thanks for your question. Yeah, go ahead, please.
The second question is just with respect to your capacity expansion in Mansfield. Is this basically kind of a completely new site? It was not completely clear also for the implant business, or is it kind of fully dedicated to the aligner business?
Yeah, thank you, Chris, for the question.
When it comes to M&A, I think that we are always—there is nothing changing when it comes to our M&A view. We are still looking at any opportunities that are in line in developing our strategic directions. We are not specifically having a very large M&A deal in mind at this moment in time. I think that was a little bit the insistence of the journalists, let's put it this way, on this topic, that Mike wanted to see more than we have to say. We believe that this M&A is still very active on our side. If, be it small or large, it's all about being able to continue to either develop our market penetration or integrate new technology or services with regard to what we need in our strategic direction. Thanks for asking the question, which allow us to clarify.
The second part on the capacity expansion in Mansfield, yes, it's a completely new site, but it's a new site because our current manufacturing facility for customized prosthetics that are done in North America is at full capacity right now, and we have no capability to expand in this location, still in Texas. It will allow us also to have new technology that we can bring in on our customized prosthetics that are allowing us to bring additional benefits to customers from an implant restoration standpoint. It will allow us also to be able to decrease costs moving forward and add those kind of digital capabilities from an operations standpoint. We are very pleased with that opportunity being very supported by the Texas state when it comes to this investment.
Okay.
On the clear aligner capacity, by how much would it enlarge your footprint relative to Arlington?
This is first dedicated to the customized prosthetic area, then more for the implant franchise business. When it comes to our clear aligner manufacturing capacity, this is still in Round Rock. We have still expanded very significantly. We had space for this. We are not constrained in Round Rock from a capacity standpoint with regard to the demand we are serving as we speak. As you said, there are significant capacity expansion in this new site, and we have taken it with this in this regard, meaning that if we were wanting also to increase in the future our manufacturing capacity of clear aligner, we would be able to leverage this site as well.
Okay. Thank you. Great quarter, by the way.
Thank you.
Thanks, Guillaume.
The next question is from David Adlington from JP Morgan. Please go ahead.
Morning, guys. Next question. Maybe just on guidance, but on the margins this side, obviously, the second half implied margin, I mean, you always see a bit of a dip given the seasonality this year. You're expecting a lot bigger dip. Just wondering, obviously, some big investment going in. Just wondering if you could just pull out a little bit more detail into the way of planning to put that investment. And then secondly, just on Dr. Smile, interested to see that you've set aside some additional consideration. Just wondered what the trigger for that was, whether that revenues or there's some other metrics that you were looking at there. Thank you.
You want to hear the first one? Yeah, go ahead.
Shall I take the first one ?
Yeah, go ahead.
Thank you for the questions, David. The first one on the margin. First of all, please be aware, if you compare the margin of the full year 2021 with our guidance and compare that to 2019, we will face a significant negative FX impact. That means if I would take the margin from 2019, the core EBIT margin, which was 27.1%, and would adjust that with FX, then this year we would significantly overachieve that margin if we reach the same level with about 2 percentage points. That is the first remark I want to make. The second one is, and we said that already after the first quarter, we expect a significant higher business activity in the second half compared to the first half this year because many restrictions are lifted. We are able to do training and educational events again. There are some smaller congresses.
There are much more promotional activities. We also increased our FTE base in the first half, as you have seen the figure, which will be fully cost-effective in the second half. I would see that also as a pre-investment this year already to prepare the growth for 2022, basically. All these factors are leading to a higher cost base in the second half, which leads to a lower margin in the second half compared to the exceptionally high margin in the first half of this year. Please do not forget our significant investing also in building up our doctor-led aligner treatment in the direct-to-consumer sales channel. That is also a significant investment that contributes to that lower margin in the second half of this year. Taking then the second question, our increase of the contingent estimation for the Dr. Smile earn-out, that is simply because
Dr. Smile business is performing above our original expectations and that we were able or we could increase our provision for the total earn-out. It is simply driven by the great performance of Dr. Smile.
Is that a revenue performance or a profitability performance or all of the above?
It is a certain mixture, but the majority is revenue performance.
Understood. Got it. Thanks very much.
The next question is from Maja Pataki from Kepler Cheuvreux. Please go ahead.
Yeah, hi. Thank you for taking my questions. I would also like to start with the second half of the year and how you see the market and your revenues performing.
Maybe specifically focusing on one statement or possibility that you discussed with full year results where you said it could well be that there is some pull forward of dental treatments due to the fact that people are saving money, they cannot really do much, sitting in home office, therefore it is a really good time to do dental treatments. Have you started to see a negative impact on demand based on the fact that things are opening up? That would be the first part of that question. Obviously saying if Delta gets a bit worse and people are stuck at home again, that could actually translate to be a positive for you rather than a negative. The second question would really be if you could give us a bit more of an insight.
You mentioned that you've managed to gain some meaningful DSO contracts during the first half of 2021. I was wondering if you could just elaborate a bit on that. Thank you very much.
Yeah, thanks, Maja, for the questions. Second half, I would say as expressed before, we are positive or very positive about the second half with regard to what we see at this moment in time. Are we seeing any negative impact of people potentially doing something else than focusing on their oral care or oral health? No. We are not seeing any of those signs as we speak because all the clinicians who I've been fortunately talked to are all very positive and reporting agenda being booked and being fully booked, which means that the delay that we can see any effect on this would not be before the fourth quarter.
That is why we still believe that the tailwind will potentially soften on a step-by-step basis, but we do not see yet any immediate effect. If there is a surge in the COVID-19 and if people would be staying at home, would that impact or improve our potential performance? Actually, we have seen that it has not been so much that which is related to our performance, but much more the fact that the clinics are open or not. It seems that as most of the countries and governments in place want to ensure business activity is still remaining active, we do not believe that practices will be closed unless there are some very various sanitary problems. We still believe that if there is some small spike of the Delta variant, the impact on our business would be relatively insignificant. The last one was about DSO.
Yes, thank you, Peter. Yes, we have done some very significant DSO win in the first half. In Europe, when it comes especially on the digital business, we've been implementing our digital workflow in different DSO in Europe, in Northern Europe, but also in Southern Europe, in Italy, with Dental Pro as an example. We have won an important DSO also in North America when it comes to the implant side with Neodent, which is called Western Dental. There has been a press release for Western Dental on this. We are still working on major opportunities moving forward. Our DSO activity is doing well. Growth is very, very solid. We believe we are currently actually gaining market share on this DSO segment.
Brilliant. Can I just double-check, Guillaume, with your statement about the second half?
From your comment, it appears that visibility on Q3 is very strong from the anecdotal feedback that you have. Is it really that momentum is expected to remain strong and potentially slow down in Q4? Is that what you're trying or we should read out from your comment?
That's what we once again, I think I will express it differently. We have always—and that was a key question during the COVID crisis—how much visibility do we have in our business? I would say it's always between 8 to 10 weeks. This is the way surgeons are working and booking their agenda. In the next 8 to 10 weeks, we have very strong evidence that the growth is going to be still solid thanks to the planning we are seeing.
Beside that, that's where we still have some question marks about is it going to be the same trend or do we see that tailwind softening? Taking into consideration that we strongly believe in our capability to keep gaining market shares and keep developing our both implant and clear aligner side, I believe that, again, our Q4 will not be disappointing. Is it going to be in the same mood that our first half. That's still the question mark that's remaining.
That's very helpful. Thank you so much.
The next question is from Veronika Dubajova from Goldman Sachs. Please go ahead.
Hi, good morning. Thank you for taking my questions. I will also keep it to two please. I'm actually going to focus a little bit on the pipeline if that's all right.
One, would love to understand, Guillaume, a little bit from you how you're thinking about sort of the building blocks and help us figure out what the opportunity for TLX is. I guess one question I have for you is kind of how is this priced versus traditional tissue-level implants? Two, kind of as you think about the market share or the incremental conversion of traditional tissue-level implants to TLX, what you think is a realistic expectation? I know in the past you've helped us think through that. If you can give some numbers around that, that would be really helpful. My second question is I know it's really difficult in terms of getting market data at the moment, but I'd love to know where you think your BLX market share is at the moment if you look at the second quarter. Thank you.
Yeah, thanks, Veronika. I think that's also a very important point about our premium franchise. We have to say we are very, very pleased with the development of our premium franchise at this moment and through the whole bounce back of the pandemic. Our TLX has to be put in the same kind of BLX segment performance because it's all about the fully tapered and the immediate segment, whether you prefer to use a bone level or a tissue level. Instead of differentiating the two, I would say that we are looking at the two implants as a joint performance for achieving our 35% market share of the immediate segment. As expressed, the immediate segment in the premium side represents 1.7 million units. We were having zero before the launch of BLX. Now with TLX, this is pushing also the overall efforts.
With regard to your question, I can say that we are in line with our objective. We should reach, my personal evaluation, above 15. We should reach 17% market share on the fully tapered segment after our two-year launch. We said that we are four years to go over 30-35%. I believe we will be able in four years from now, in four years after launch, meaning in two years from now, to go to that 30-35% because we are very solid in the trend and our volume is really, yeah, showing that we're achieving this very ambitious objective.
Understood. Thank you very much.
The next question is from Julien Denoir, Aix-en-Villaine, Pays-Pari-Bas. Please go ahead.
Hi, good morning, Guillaume. Good morning, Peter. I hope you can hear me okay. I hope you're well.
I have two questions, please, on the clear aligner business. The first one relates to the profitability of that segment. Particularly, we've seen that some of the largest DTC players in the U.S. are really struggling with profitability due to the rising competition and the constantly rising cost of acquiring patients. It would be very helpful if you could tell us how you see the profitability of Dr. Smile evolving in the next five to 10 years and how you can make it much more profitable than what is currently visible in the U.S.. The second question is quite basic and here again relates to DTC in the U.S.. We've seen you be very active on the DTC segment in Europe with Dr. Smile, very successful. Now you're doing a move in Brazil. Do you intend to move into the U.S. at some point?
What could be the strategy for you in the U.S. going forward?
Yeah, thank you, Julienne. When it comes to Dr. Smile profitability, obviously when you are in a very, very strong growth and land-grabbing exercise with very, very top-line growth, we are favoring all the top-line developments as we speak in order to make sure that we are going to be leading or in a leading position in this segment and benefit from the lead direct-to-consumer is allowing us to have a significant synergy with our regular B2B side. While the customer position, direct-to-consumer, yes, is one of the very important unit economics, this is not the only one in this business model because we are also leveraging the possibility to acquire patients from the existing doctor base where the cost has nothing to see with that only direct online acquisition.
We believe that this business model is the right one when it comes to the clear aligner segment. We will push this business model forward and not do this direct-to-consumer with only the online acquisition, which is costing very, very much, especially when you have a competitive intensity which is very high, as it is the case in North America with so many players already. When it comes to the DTC in Europe, in North America, the reason why we are investing in Brazil is because it is really at the beginning of that segment and that business model. We believe that we can also deliver some significant growth and a leading position at the right moment in time. This is why we have done this move.
When it comes to the U.S., there is way too much competitive intensity to deliver some profitability in a pure DTC model. This is why we have not made any move so far. Actually, we have all seen some of the major players that had some disappointing reasons lead to that customer acquisition cost. We are developing, once again, with some partners, some business model that are going to allow us to have direct-to-consumer activities, but we're still leveraging our clinician network. This is a work in progress. We still believe that by 2022, we would have some activity in line with this business model in the U.S., but it will not be a pure DTC activity once again, as you are seeing some of the leading players in this segment in the U.S..
Okay. That's very helpful. Thank you.
If I may, just one follow-up. When do you think you could become profitable with Dr. Smile specifically? Is that a 2022 thing or maybe more towards 2023, 2024?
It is all up to Dr. Smile can potentially be profitable today if we were not investing in land-grabbing. You see that we are present in more than 10 European countries where in the past, let's say, 16 months, we increased this number by eight. They were present in two countries, Germany and Austria. You have, of course, a significant investment to be done here in order to continue developing this leading presence. We are, once again, not wanting to have profitability very short term, but we see that much more from a midterm basis in order to continue creating this leading position.
I would say Dr. Smile would be profitable for us, I think, in between a three- to five-year period, depending on, again, the level of acceleration we want to put in this business. It has been really above our expectations, as you have been able to see with the earn-out payment adaptation that we had to do.
Okay. Very helpful. Thank you very much. And well done for the strong quarter.
Thank you.
The next question is from Oliver Metzger from Odo. Please go ahead.
Yeah. Good morning, gentlemen. Two questions from my side. The first one is, could you share with us your view about the underlying growth dynamics for the premium sub-segments of parallel, epically, and fully tapered implants for the market? That's number one. Number two, it's a very general question for the digital solution business. You now have a pretty holistic offering.
How does the order behavior of your customers, in particular GPs and the dental technicians, have developed over the last years? Do you observe a trend towards a one-stop-shop mentality, or is it still quite profound cherry-picking behavior from them?
Yep. Thanks, Oliver. On the underlying reasons for our premium, epically and fully tapered reasons, the first reason is when it comes to the fully tapered is market share gains, no doubt. It is leveraging our innovation power, leveraging our really very strong sales team, and especially the Straumann brand, reliability, and quality. This is really allowing us with very strong execution to leverage the quality of that BLX and TLX innovation.
For the epically tapered, something that I'm happy to share with you and everyone is that when we have looked at our BLX number, as said in the comments, 25% of those customers are really new customers to Straumann that we never worked with. And out of those new customers to Straumann, then all of them, or 70% of them, in between 70-75, are using now other implant lines and mainly epically tapered implants on top of BLX. We are seeing, really, as we were expecting, a very significant pull-through effect of BLX towards the BLT performance. We are expecting continuing market share of BLT despite our already 40% plus market penetration. That are the really underlying factors of epically and fully tapered on top of all the digital activity, marketing activity that we are doing to ensure our category leadership.
Looking at digital solution, I'm not sure I understood exactly your question, Oliver. Can I kindly ask you to express it once again?
Yeah. You have a quite holistic portfolio. And is it that your customers, in particular, were GPs and dental technicians. Some years ago, it was about you have not had a portfolio, and they looked for each product for a best potential solution. Is this kind of cherry-picking between different suppliers still the case, or do you observe that your customers now basically order all the tech or all the digital equipment from you?
Oh, yeah. Okay. Thank you for the precision. Yeah. We see on the digital equipment side, this very strong trend on digital equipment continued during the whole 2021, and especially on the iOS side, the intraoral scanner.
We are seeing some development also on the 3D printer, and having the Straumann digital workflow is obviously helping us to combine the equipment. I would say, on the one hand, especially on the chair side, when it comes to dentists, they are looking forward more to having an integrated system than, let's say, cherry-picking the different units. When it comes to labs, they are the ones being able to adapt technology from different suppliers, from different workflows. They are the ones still doing some cherry-picking in between their scanner lab, the 3D printer, some other technologies. I would say that's two very different behaviors that we are seeing here. Labs are really a target group which know a lot about technology, while clinicians are really looking forward to simplicity, efficiency, and one system.
Now, this being said, all clinicians are really looking at intraoral scanner, especially, and I would say almost only because they all want to participate in this digital workflow, explaining a lot also of our very solid results on our business unit digital, where our intraoral scanner, thanks to covering all our price points, we appreciate Medit and Straumann Virtuo Vivo from Dental Wings, allowing us to capture a lot of those different opportunities.
Okay. Great. That was helpful. Thank you very much.
The next question is from Daniel Jelovcan from Mirabel. Please go ahead.
Yeah. Hello as well. Just on Germany, I was positively surprised that you mentioned that growth was also strong there. I mean, I always thought Germany already had was not so much affected during the pandemic. And so maybe you can shed some more light on that. That's the first question.
Yeah.
I think Germany has been less affected by the pandemic. This is correct. On the other hand, I think we have a strong opportunity with not only our BLX and the different segments, but also about our value segment where we were not present, and of course, on the clear aligner side. I would say that Germany is representing well our capacity to grow beyond the tailwind from the pandemic by market share gain and by growing our new categories. This is a lot one of the reasons why we are growing in Germany by a strong execution, market share gain, and developing then iOS especially, and the clear aligner business.
Okay. Actually, very good indicator what can happen post-pandemic. Okay. Interesting. The second question, maybe a stupid one, but on slide 21, you showed your segmentation like always.
I mean, not seeing you, but wouldn't it make sense to also launch a tissue-level epically tapered? So a TLT, or is that technically doesn't that makes no sense?
I mean, seeing, Daniel, I'm impressed. You are spot on. You are spot on. I'm saying that really, that's right. Based on the numbers we gave you, you see that this epically tapered is the lion's share of the total market. That's benefiting from a tissue level on the epically tapered segment with that neck for simplicity on prosthetics should be a very, very strong opportunity for growing then the GP side on the premium segment, and it's actually in our innovation pipeline.
One of the things we want to be able to do, which is a big project that we are doing at the moment, is being able to help the clinician to choose the design of the implant they want to use while still using the same surgical cassette and able to rationalize everything on their side, but still having the flexibility to use the technology they want in a very simple manner. We are looking into this, and the TLT will be in the pipeline for the years to come.
Okay. That's great. Actually, tissue level in general, TLX or TLT, is primarily a target for the GP market. Is that correct, or simply?
The TLT side, yes.
For the TLX, it allows some GPs to do immediate treatment, but it's also interesting for specialists on the TLX side because this is simplifying some of the techniques for fully edentulous. I would say that mainly the TLT would be specifically for the GPs, even though specialists would be able to use it as well because we know that they are using the two designs in their practice. The TLX being more for, and I would even not say GP or specialist, but for advanced practitioners that are used to this kind of fully tapered design.
Excellent. Yeah. Thanks very much.
The next question is from Daniel Buchta from ZKB. Please go ahead.
Yeah. Thank you very much. Two questions also from my side, little ones.
First one, I mean, if I listen to what SmileDirectClub just recently said with their Q2 release, they mentioned in the U.S. they have seen a weaker macro environment, which was a very flowerish word of how to call that. Is that something you see kind of as well in the U.S.? I mean, because if I see Align, they had strong results. If I listen to what you said on your clear aligner business, at least globally, also the demand seems to be very healthy. Is there anything you see in the U.S. clear aligner market? Also on the Smiling acquisition, I mean, obviously, if I see the numbers in your report, quite small in terms of what you pay for it. What is the potential with that, and how does the market look like in Brazil for direct-to-consumer?
Is the potential, I mean, in terms of getting the size similar to what you are doing now with Dr. Smile, or how is that to be seen? Thank you very much.
Yeah. Thanks, Daniel. To be very, very blunt, we have not seen any weaker microeconomic environment in the U.S. when it comes to our business. For us, I would say we have seen more an environment that has been positive for supporting our business to grow and for dental practice to get a very healthy patient flow. When it comes to the SmileLink, Brazil is, again, a very aesthetic-oriented country. We know that clear aligner, and we see, is growing fast, especially with our B2B business, and that this segment of doctor-led D2C activity will obviously take a significant share of the simple cases.
Volume-wise, I think it will be potentially as large as Dr. Smile in the future if we are developing well. Now, value-wise, it's a very different story because, as you can imagine, ASPs will be very different from Brazil to Germany. We will have local manufacturing, which is helping us also to keep costs at a reasonable level and having all our operational responsibility also over there. That is why we believe it was a good opportunity for us to benefit from this very strong growth on those simple cases coming from that doctor-led D2C segment.
Okay. Very interesting. Thank you very much.
Today's last question is from Marcus Gola from Stiefel. Please go ahead.
Great. Good morning, and thank you for taking my question. I wonder whether you have experienced any meaningful supply chain problems or challenges to source your key raw materials.
Maybe more important, how have prices developed for your main raw materials in the current environment so far, and are you able to fully pass on these price increases to your customers? Thank you.
Yeah. Thank you, Marcus. Also a very good question on the supply chain. We have to say we had a bit more tension on our supply chain in the first quarter on some material, but honestly, nothing that has disrupted our supply chain. We have been able now, with all our suppliers, to ensure a much lower tension than we had during the first half. We do not see really any significant cloud on this side. When it comes to inflation, which is one of the topics we are hearing, of course, here and there, honestly, we have not seen significant price increase on our raw materials so far.
We have not seen, again, major tension like it's the case on some electronic parts or technology parts. That is the good side of it, except a little bit, I would say, on the logistics side has been more expensive. With regard to our raw material cost, it's not the major part of our cost. It has not significant influence on any of our gross margin.
Great. Thank you.
Okay. Thank you, Chris Cole. I would like to thank you for your questions and for joining us today. We look forward to seeing you again soon and wish you, your colleagues, and families the best of health and a good start after the summer break. Have a nice day and goodbye from Basel.