Good morning. Thank you, everyone, for joining us. Just a quick reminder: we would like to get started promptly at 10:00 A.M., so grab a cup of coffee or a snack and come in and join us in the room. A quick, just reminder, if you haven't already provided a business card to the little glass bowl inside the product café, we are going to raffle off two Invisalign Ultrasonic Cleaners for those of you in treatment or about to begin treatment or for a family member. If you haven't dropped off a business card, please do that before the end of the meeting today.
Music that makes you feel good, makes you feel understood, like you're not alone, not a rolling stone, not the only one on the road. Oh yeah, all right, trying to make sense of it all tonight. Oh no, here we go, this won't be the last time. Oh yeah, oh yeah, all right, trying to make sense of it all tonight. Oh no, oh no, here we go, this won't be the last time. It all seemed pretty plausible, but it became impossible, the promises you made and you got betrayed and all the things that you still don't know at the end of the day. Oh yeah, oh yeah, all right, trying to make sense of it all tonight. Oh no, oh no, here we go, this won't be the last time. Oh yeah, oh yeah, all right, trying to make sense of it all tonight.
Oh no, oh no, here we go, this won't be the last time.
I say I'm too late, got nothing in my brain. That's what people say, mm-hmm, that's what people say, mm-hmm. I go on too many dates, but I can't make them stay. At least that's what people say, mm-hmm, that's what people say, mm-hmm. I keep cruising, can't stop, won't stop moving. It's like I got this music in my mind saying it's gonna be all right 'cause the players gonna play, play, play, play, play, and the haters gonna hate, hate, hate, hate, hate. Baby, I'm just gonna shake, shake, shake, shake, shake, shake it off, shake it off. Heartbreak is gonna break, break, break, break, break, and the fake is gonna fake, fake, fake, fake, fake. Baby, I'm just gonna shake, shake, shake, shake, shake, shake it off, shake it off. I never miss a beat.
I'm lightning on my feet, and that's what they don't see, mm-hmm, that's what they don't see, mm-hmm. I'm dancing on my own, dancing on my own. I make the moves up as I go, moves up as I go, and that's what they don't know, mm-hmm, that's what they don't know, mm-hmm. I keep cruising, can't stop, won't stop moving. It's like I got this music in my mind saying it's gonna be all right 'cause the players gonna play, play, play, play, play, and the haters gonna hate, hate, hate, hate, hate. Baby, I'm just gonna shake, shake, shake, shake, shake, shake it off, shake it off. Heartbreak is gonna break, break, break, break, break, and the fake is gonna fake, fake, fake, fake, fake. Baby, I'm just gonna shake, shake, shake, shake, shake, shake it off, shake it off, shake it off, shake it off.
I shake it off, shake it off. I shake it off, shake it off. I shake it off, shake it off.
Hey, hey, hey, just think while you've been getting down and out about the liars and the dirty, dirty cheats of the world, you could have been getting down to this sick beat. My ex-man brought his new girlfriend. She's like, "Oh my God, but I'm just gonna shake into the fella over there with the hella good hair. Won't you come on over, baby? We can shake, shake, shake." Yeah, 'cause the players gonna play, play, play, play, play, and the haters gonna hate, haters gonna.
Good morning. If we could have everyone come in and take your seats, our program will begin in just a couple moments. Thank you.
Fake is gonna fake, fake, fake, fake, fake. It's gonna shake, shake, shake, shake, shake. Shake it off, shake it off. Shake it off, shake it off. I, I, I shake it off, shake it off. I, I, I shake it off, shake it off. I, I, I shake it off, shake it off. Shake it off, shake it off. I, I, I shake it off, shake it off. You got to shake it off, shake it off. I, I, I shake it off, shake it off.
I was thinking to head to Dallas already, John, but I thought.
Stopped me on the corner. Swear you hit me like a vision. I, I wasn't expecting. Who am I to tell fate where it's supposed to go with it? Don't you blink, you might miss it. See, we got a right to just love it or leave it, you find it and keep it, 'cause it ain't every day you get the chance to say, "Oh, this is how it starts." Lightning strikes the heart. It goes off like a gun, brighter than the sun. Oh, we could be the stars falling from the sky, shining how we want, brighter than the sun. I've never seen it. I found this love, I'm gonna feed it. You better believe I'm gonna treat it better than anything I've ever had, 'cause you're so damn beautiful, read it. It's signed and delivered, let's seal it.
Boy, we go together like peanuts and pâtés, Marley and Reggae, and everybody needs to get a chance to say, "Oh, this is how it starts." Lightning strikes the heart. It goes off like a gun, brighter than the sun. Oh, we could be the stars falling from the sky, shining how we want, brighter than the sun. Everything is like a whiteout, 'cause we should, could, should, could shine down, even when the lights out. I can see you glow. Got my head up in the rafters. Got me happy ever after. Never felt this way before. Ain't felt this way. You hit me like a vision. I wasn't expecting. Who am I to tell fate where it's supposed to go? Oh, this is how it starts. Lightning strikes the heart. It goes off like a gun, brighter than the sun.
Oh, we could be the stars falling from the sky, shining how we want, brighter than the sun. Oh, this is how it starts. Lightning strikes the heart. It goes off like a gun, brighter than the sun. Oh, we could be the stars falling from the sky, shining how we want, brighter than the sun. Brighter than the sun. Brighter than the sun. Brighter than the sun. Yeah.
This is how it starts. Lightning strikes the heart. It goes off like a gun, brighter than the sun. This is how it starts. Lightning strikes the heart. It goes off like a gun, brighter than the sun. Oh, this is how it starts. Lightning strikes the heart. It goes off like a gun, brighter than the sun. Oh, this is how it starts. Lightning strikes the heart.
It goes off like a gun, brighter than the sun.
Hot dog ready to go. I got my eyes on the path. I'm sick of feeling the loath. I wanna roll with the odds. I took a different path. I did it all on my own, so. Whole world ready for me. I got a vision in mind. It's time to roll up my sleeves. You know I'm feeling alive. I took a different path. I did it all on my own, so. I've been hoping that my dreams come true, and I'm hoping that I make it with you.
One, two, three, four.
Count it out, count it out. One, two, three, four, five, six. Hook it up, hook it up. Think we're gonna make it. Shout it out, shout it out. One, two, three, four, five, six. Do you feel the vibe? Count it out, count it out. Let me hear your zip code. Hook it up, hook it up. Feeling like a grango. Worldwide, worldwide. One, two, three, four, five, six. Do you feel the vibe? Hopped up, look at us go. We could shoot for the stars. Gonna start a parade. Say the future is ours. It's a beautiful day. We did it all on our own, so. I've been hoping that my dreams come true, and I'm hoping that I make it with you.
One, two, three, four.
Count it out, count it out. One, two, three, four, five, six. Hook it up, hook it up. Think we're gonna make it. Shout it out, shout it out. One, two, three, four, five, six. Do you feel the vibe? Count it out, count it out. Let me hear your zip code. Hook it up, hook it up. Feeling like a grango. Worldwide, worldwide. One, two, three, four, five, six. Do you feel the vibe? Do you feel the vibe? Do you feel the vibe? Do you feel the vibe? Hopped up, ready to go. I got my eyes on the prize. I'm sick of feeling the loads. I wanna roll with the odds. I took a different path. I did it all on my own, so. Hopped up, look at us go. We could shoot for the stars. Gonna start a parade. Say the future is ours.
It's a beautiful day.
Please welcome to the stage, Shirley Stacy.
Good morning. Thanks for joining. Great to see everyone here in New York. Those of you online, welcome. Real quick things I want to cover for our 2025 Investor Day. A couple of quick housekeeping items. The meeting's being webcast, obviously, online, and there's a link on our website if anyone needs access to it. We will be posting the slides within the next day or two. If you're looking for those slides, those will be online. The meeting is being recorded, and there is Wi-Fi in the room. If you need the password, the Wi-Fi is on a tabletop right in front of you. We also appreciate that those of you who came during registration and went to the product cafe had an opportunity to get a face scan and an iTero Lumina scan.
That will be available to you if you miss that opportunity to do that during the break or at the reception at the end of the day. Housekeeping, restrooms all the way down the hall in the very back past the elevators. For the Q&A session today at the very end of the day, just a reminder, there will be mics running up and down the aisles. We want to make sure we capture your questions. If you do not mind waiting for somebody to bring a mic to you, that would be fantastic. I think, oh, one last thing, and I said it earlier in case you missed it. We are raffling off some ultrasonic and Invisalign Ultrasonic Cleaners. Put your business card in the glass bowl at the product cafe if you get a chance. Now, on to the super important things.
As you all know, this is our safe harbor and forward-looking statements disclosure. This will also be posted on our website. I refer you to the company's filings and disclosures on our website and at sec.gov. Non-GAAP financial measures and any of the reconciliations also available on our website and will be posted with our presentation. We have a packed full agenda today, and we're super excited to have the Align leadership team here with you today along with other extended members of our management team. Really want to spend time with you during the breaks and in the reception and Q&A afterwards. Look forward to follow-on discussion after our presentations. With that, I would like to turn the meeting over to our President and CEO, Joe Hogan. Thank you.
I'll use the stairs, Shirley. Thanks. Hey, good morning, everyone. Great to have you on a sunny New York day. Doesn't ever disappoint me when I'm here, for sure. This is my title slide, but honestly, if you just look at this slide, digital transformation is going to talk about a 30-year journey of Align's digital transformation. And then secondly, practice efficiency and patient experience. It's where our technology goes. It's our salespeople and conversion people knock on doors of dentists and orthodontists all around the world moving forward from a digital technology standpoint and how it changes dentistry. These slides here will reinforce how we're getting about that and what we think the future looks like. Overall, digitizing orthodontics, and the takeaway here is making tooth movement a standard of care.
It has not been a standard of care historically because it can only be done with wires and brackets and by a very elite group of orthodontists that do that around the world in an incredibly technical way to do that. With the digitization and aligners, you can take there is this breadth that you can use as far as straightening teeth for different reasons. We will go over that today. Želko has a really great presentation on how to break that into general dentistry through labs that we will talk about more later on. Overall, empowering doctors, in other words, giving them technology that they can face consumers with and explain not just abstractly, but with a scan and a diagnosis that you can share from a consumer standpoint exactly what you are going through. To me, dentistry has been a dark art for most of my life.
You had to really trust your doctors. You had to trust your technician of what's going on. Now you can be a partner like you are in the medical device industry where you can just see exactly what you're dealing with. You can see it upfront. You can have those discussions, and you can make intelligent decisions about how you want to go forward with your therapy. Enhancing patient experience. I think if you had a scan out there, you can see that right away. Increasing practice efficiency. Digital does lead to efficiency. The way that we program these things and how fast we can do things now versus even 10 or 20 years ago is incredible. Okay? Expanding access to care.
When you have this, when it's digital and you can spread that across the board, it's not just from a North America standpoint, from a global standpoint. It's not just an orthodontic place. It's a dental place also. I'm going to take more time on this slide than any other slides we have. We're on a 30-year journey. We're 28 years into it. And this is a technical journey on digitalization. If you go back to what I'm calling digital is esoteric, 2000 to 2010. The title is Scale and Clinical Viability. What we had was an idea of how you could move teeth with plastic, which is ultimately digital. But there's a lot of systems that had to be in place in order to do that. There was no company in the world that could do it because they weren't focused on it.
We had to do it ourselves. It took a lot of money and time to do it. You can look. Start with, from 100 patients to a million patients during that period of time. Displacement-driven systems. Shirley will talk about it today. Shirley's taken us from there all the way to 3D printing now. Shirley will talk about how we do treatment planning, how that works. Displacement technology, to me, is just simple 2D technology. The teeth are here now. I'm going to create another aligner where those teeth should be, and it moves. What we have learned to do over the years is actually load that particular aligner with the right polymer to load it almost three-dimensionally on how to move teeth. You can rotate the teeth. You can extrude the teeth, right? You can spread the teeth apart, those kind of things.
You couldn't do that initially. We didn't know how to do it. We had to invent that technology. Our clinical viability, fancy name for how many patients we could do in the sense of walking into the office, about 30% we could cover in those first 10 years. They were all adults. Teens were a little bit too difficult for us to 3D printing SLA. There were 3D printers back then. Nothing at scale. It's a prototype industry. Today, outside of centering technology, it's still a prototype industry today. Emory Wright is going to talk to you about 3D printing and how we're going forward with it. One of the pioneers that we figured out how to do this. Yeah, we used 3D Systems printers. We used 3D Systems types of resin, but they didn't know how to get to a million aligners a year.
They have no way to stretch your equipment that way. We had to take the equipment. We had to modify it. We had to make sure that the resin was proper, that you could do that on that scale. It took us years and millions and millions of dollars in order to scale that business in those first 10 years. No one knows how to do it even today. Okay? 3D printing SLA, single-layer material. The polymer science that encapsulates the code that Shirley and her team writes that moves the teeth, the polymer has to be a way it can express that code as well as possible. I grew up in polymer science. My first jobs were GE Plastics or whatever.
It's hard to find one single polymer that can do everything you want to because ultimately you run in this thing with polymer science where you need ductility, you need rigidity. Those two things are countervailing in a sense of a molecular structure of a material to make that happen, right? We started off with a single-layer material. I think it was a urethane-based polymer that moved teeth fairly well. That's what we had to deal with, and that's what we went forward on, right? Clinical accuracy, ClinCheck was almost completely analog, right? We'd go back and forth. It was nothing but PVS impressions down at the bottom. If you were going to look at an Invisalign case, you're going to get a bunch of goop in your mouth. You're going to wait till it hardens.
You're going to put it in a box as a doctor. You're going to ship it down to Mexico at that point in time. They're going to put it on a CT scanner, actually a GTC scanner to give you an impression, right? Once you had that digital format, then we could work on it from the ClinCheck. Everything we had, the point is we couldn't take anything from industry. There was nothing there that fit this business model, but we had to do. We had to make it ourselves. The last is Invisalign wouldn't be here today if we didn't consume or advertise because there's no way a doctor really wanted to do Invisalign. It was hard to do. It's a different science altogether. Unless a patient came in and insisted on it, they were not going to get it.
That saved Align. I don't think Align would have ever had the investment money and time in those 10 years to do what we did if we didn't have a certain amount of adult patients that just said, "Hey, this is what I want. This is what I can do." It got the company going. That today, obviously, our consumer part is still a big play for us in the sense of pushing on orthodontists, pushing on GPs for patients asking for Invisalign treatment. First 10 years, a struggle to scale, I would call it. Okay? That is why digital is esoteric because we're kind of halfway there. 2011, 2020, digital is hybrid. We're almost right in between analog and digital and fully digital. Just walk down biomechanics and ML software.
We started to learn the biomechanics of how do you load that aligner to really move teeth in a complex way. Clinical viability moved 80%, especially when we got to Invisalign First in 2017. We were really deficient in the teens area. That product, which is an arch expansion, and Shirley will go over, it is a terrific product in that way. It really took us in a teen market in a way that we couldn't get there before. Okay? Multilayer SmartTrack material combined a polyester with a polyurethane that had that span, that rigidity and ductility spectrum that you needed to really move teeth the way we wanted to. An incredible breakthrough for us in the sense of having our algorithms properly expressed in that aligner to move the teeth. Okay? 1 million aligners a day. We finally scaled to doing 1 million aligners today.
I don't think there's been any company in history that actually has made 1 million absolutely unique products. This is mass customization. I can't think of any other industry I've ever seen, read about, or been part of that got to that part of mass customization. That was a long journey for us to really understand it and get it to that point. Okay? ClinCheck, scale, and efficiency. At some point with ClinCheck, we moved ClinCheck to the cloud from just a server-based system. That opened up dramatically what we could do with ClinCheck and how fast we could work back and forth with doctors all around the world. Shirley will talk about that today. She and her team have done a great job of really bringing that to the next level overall.
Consumer brand scaling, you know, through that period of time, obviously with Google and different areas and different ways to go to consumers. We've been capitalizing on that. It helps the brand and helps us drive business. At this point in time, though, between 2011, we're still on PVS scans of only 50%, roughly. Remember, every time you do a PVS scan, 7-8% of them are rejected. You put it in a cardboard box, you ship it somewhere, you call the doctor back, say it doesn't work or whatever. It was just a messy analog system in the front of a, I'd say, rapidly maturing digital kind of system we were doing with treatment planning. Move over to 2021 and 2030, hundreds of millions of dollars of investment, okay, in three key areas. Best scanner in the world that's not a scanner anymore.
It's not a PVS impression device. It's the front end of our digital ecosystem that we'll cover for you today. It's just a window on your teeth. It's a window on your oral health. It's a tool for patient communications and an incredible tool for doctors too. Okay? Biomechanics, ML, and AI software. I mean, we've always been doing machine learning here. With AI, and I know every CEO in the world talks about AI. With the amount of data we have, 20 million patients, and the depth and understanding of that technology, machine learning and AI just fits well. With AI really starting to scale now globally, it really helps us to even be more efficient in that area. Clinical viability is now 100%. We can do any case in Invisalign.
We really crossed that chasm when we got to mandibular advancement with occlusal blocks we launched recently and then Invisalign palate expander for kids. We will go through those products. Now we can comfortably say a doctor cannot honestly say to anyone, "Invisalign cannot handle your case." A doctor might have a preference in the sense of what they want to do, but clinically, we can do that case. We probably can do it six months faster with more predictability and obviously a lot more patient comfort than you would have with an analog process. We are going to talk a lot today about direct 3D printing. The dream in this business since the time we started scaling back in early 2000 was, goodness, we print a mold, we vacuum form an aligner over top of it. You cannot change the wall thickness.
You can't add different designs to it or whatever. You're frozen in that 30-millimeter sheet of plastic that you have to pull down over that mold. Orthodontists, ideally, and GPs, ideally, will want different wall thicknesses and want different pieces for different patients in different ways. We couldn't really offer that unless it was some kind of adjunct hands-on process that had a lot of cost to each aligner in order to do it. Secondly, 95% of the plastics we use were tossed out, thermally recycled or put in the floor tile or whatever. 95% of them were gone because you're just using molds from an SLA printing standpoint. The trim that you would have around the vacuum form plastic would be gone. With 3D printing, absolute design flexibility. Put as much wall thickness, adjacencies, or whatever you want to do on that.
Secondly, a much more efficient kind of a process. No one could get us there. Shirley will talk and take us through there. Shirley started here. Shirley's been here for almost the whole existence of the company and took us through the point that we have our own polymer. We have our own process. We'll walk you through what that is. We're back to where we were 20 years ago. We got to scale a new process to get it up to millions of parts a day. ClinCheck. So ClinCheck, remember, ClinCheck is that critical interface between a scan and us doing the diagnosis and sending it back to the doctor in some way. Through what we call IPE protocols, and Shirley will talk about today, probably at the end of this year, about 20% of this will be touchless.
Remember, this used to take maybe four weeks to do back in that period between 2010 and 2010. Back and forth, doctor wants to change something. We have to change it, send it back. Can we manufacture it or whatever? Today, you can scan. In minutes, you can have your protocols. You can get on 3D controls, which is kind of like Photoshop, change the teeth what you want. If it's within the parameters we think make sense, you hit a button and it goes. Millions of lines of code and dollars and time in order to make that happen. We're setting on a precipice where we think in this period to now to 2030, we'll be doing 80% of the clean checks will be touchless in that sense. You scan, protocols are done. Immediately, the patient sees what it is.
Hopefully, we have aligners to them within seven days. Okay? Scaling to 2 million aligners a day, 3 million aligners a day is where we have to get. We have to get that with our 3D printing capability. Invisalign, brand number one for teens and adults. The teen piece is really important now because we are 100% of the product. We're going to be heavily advertising toward teens because in the orthodontic market, it's still 75-80% of the marketplace. We have a portfolio that's much better for those teens. You'll see that come out today. 100% IOS. IOS is intraoral scanning. Again, not a PVS impression. This is about diagnostics now. It's a window to your oral health that we can actually provide.
Again, a great conversation piece for consumers that are sitting in that chair, but also for doctors in the sense of how to develop that therapy. Thirty million patients plus when you hit that. There has been a huge amount of time, momentum, and effort in those three areas to take us to where we will go over the next couple of years. You will see this come to fruition. I thought, you know, this is interesting. It's just that if you take a look at a glance on the top, total revenues. What grabs me here is I just want to just show from a clear aligner standpoint versus iTero on a scanning standpoint. It's not a big change, but it was about 14% in 2018 and moving to 19%.
It should always be in that 15-20% range in the sense of the scanner revenue versus Invisalign. As you put your models together and you think about it, I think it's just a good grounding for you. Secondly, when you look at clear aligner volumes, ortho versus GP. On the left, you could see in 2018, GPs were 35% of what we did, and orthos were 65%. Move to the right, obviously, roughly six years later, it's like the same. What that tells me is that the GPs aren't stealing from the orthos. We're just growing this market, 1.3 million overall in this whole thing in cases. We're just growing this market together. That GP market is just as big as opportunity as ortho. It's not that the GPs are stealing the orthos' business.
They can peacefully coexist together because there's two different ways of doing this now. Aligner, clear aligner volume, regional mix. I think as you put your models together and you try to figure out or project how Align's going to grow, this is a good look at Americas that was back in 2018 about 59% and then 17% in APAC and 24% in EMEA. You lose about roughly seven points on the Americas side over. The business is growing, again, $1.3 million. You just get a much better kind of around this in the sense of the geography and what we sell to. I don't think this is going to change relatively dramatically because within the Americas, we have Brazil, Latin America that's growing well. America still has a great growth profile in both GPs and also ortho's.
I think, again, when you look at 2018 to 2024, not a dramatic difference, but the Americas does not constitute as much of our success as it did in the past. Clear aligner shift to teens and kids. We look at the teens volume overall. This is a big jump when you think of teens, again, are 80% of the marketplace from an orthodontic practice standpoint. Back in 2018, we were about 73% adult, 27% teen. We have gained significantly to 35% on the teen side and 65% on the adult. You will see that today. A lot of that came from kids. Not permanent dentition teens, but it came from Invisalign Palate Expander. It came from Invisalign First, one of the most successful products we have ever launched, and also mandibular advancement. Those young ages where you can move bone as well as teeth and actually do facial reconstruction.
We've been very successful in that area. It really helps to round out our portfolio, not just in the U.S., but all around the world. To me, it's great to see that teen growing in that sense because we poured so much money and time from a business standpoint to address that marketplace. Just taking it all back just to ground you. 75% of the world has a malocclusion. What's that mean? It means if you don't have your teeth fixed, you're losing enamel every day. You're just losing enamel because your bite's not right. You're going to gradually lose enamel. If you lose enamel, it's the most important part of your oral health. It's not just about aesthetics with Invisalign. It's about oral health overall and saving enamel. Digital opportunity, 2 million doctors out there. We have about 100,000 Lumina scanners.
Karim will give you a good talk on Lumina. Lumina is a breakthrough in technology. We've invested in it for upwards of six years to get to where we are today. We really wanted to move beyond confocal imaging because there's some design constraints there and capability. We wanted what I would call almost a true medical device is what Lumina is in the sense of how it's structured. Karim will take you through it. We couldn't be more thrilled in the sense of how this product's launched, the overall acceptance in the marketplace, and a platform that we can really scale and grow from too. GPs. The GP market is a great market. It's a fascinating market for us too. 75% of the people I mentioned have the malocclusion. That's a tooth movement piece. GPs can get at it. We've done really well.
Obviously, with Heartland, we talk about it in our quarterly reviews, how well we've done with different DSOs that can help to multiply the effect of getting that message out there. In the comprehensive dentistry sense, in the restorative sense, there's a lot of enamel being lost. When you have an implant or when you do an aesthetic procedure on your social six, there's a lot of times that you're going to carve off enamel of the adjacency of the implant, or you're going to carve enamel off your front teeth if it's done at a GP practice without moving them. What Želko is going to explain to you is how, in conjunction with Exocad, we're going after that market to have people save enamel. You avoid that kind of shaving off of enamel.
You move the teeth first, and then you apply what we call an ortho procedure, ortho restorative procedure behind it. It's a big marketplace for us out there. It's one we're excited about and where the Exocad acquisition that we did several years ago makes sense. 22 million case starts per year. We got 10% market share. Teens still the majority of the marketplace. Adults, we're kind of reversed on share, 30% adults, 10% share on teens. We know teens is a holy grail. That's the marketplace in ortho. That's why we're so focused on our portfolio. You get to 3D printing. When you get to five-minute ClinCheck or a ClinCheck in minutes, you have Lumina scanners in the case it is. We have technology that makes it.
One of the big questions is going to be in there, why haven't you grown for three years? What's been going on with this business overall? A lot of it, we can point to market. In my next slide, we'll deal with that, and we'll talk about it in general. There is a lot of friction.
If you're an analog doctor, whether it's on GP or if it's on the ortho side, and you look at the Invisalign system, I think it's almost unfathomable for doctors sometimes to say, "I have to change everything in my office to make this work." When we talk about minute clean checks and we talk about Lumina, how fast it is, what we're trying to do is take the friction out of the system and to make it much easier for doctors to be able to adopt our system and not have to contemplate a year-long kind of a journey of moving their practice from analog to digital, especially in a time from an economic standpoint where they might have concerns on patient flow. This is how 22 million case start, orthodontic starts a year spread out. It's pretty equal all around the globe.
Americas and APAC the same and 6 million in Europe. Back to that question about why we haven't grown in the future. A big part of it, this is unprecedented that the orthodontic market in the U.S. would be down three years sequentially. It's never happened before. Why is that? I think some of it could be a COVID overhang. It was such a growth rush back in 2021. There could have been some pull forward there. Obviously, the economic circumstances haven't been helpful in that sense. That's the numbers on the orthodontic side. I'm not predicting the demise of the U.S. orthodontic industry. This is going to recover. It's a strong industry. Orthos are very secure from a financial standpoint. It's just that patient throughput has been down for three years, which is unprecedented.
I'm confident that that'll come back and that market will strengthen again in the near future. Future of teen orthodontic deal. This is, we have people in this room that have been here over 25 years. They've been on this whole journey almost 28 years. And this is what gets us. 84% of prospective teen patients prefer Invisalign clear aligners over traditional metals and brackets. When they walk into an orthodontist today in the United States, 30% might get it. 25% might get it when they ask for it. Right? Our job is to make sure we remove that friction, remove any concerns that those orthodontists have technology and can look at this as well as a business opportunity, as well as it is a clinical opportunity for them. Now, I'm pleased when you look at Q1 2024 and Q1 2025, we're up double digits, 13.3% in teens.
That's almost unprecedented for us over the years to see teens grow that way. Again, IPE, Invisalign First, MAOB are helping to lead the way. On this slide, I want to just get a few points, and then I'll get off the stage here. One is we're navigating a very dynamic market right now when you look at it globally. I think we all know what's going on globally. I think we're navigating it well. We reported in the earnings where we are in tariffs and different things. On wires and brackets, when you think about competition, you ask about competition, our biggest competitor in the world are wires and brackets, by far, but still. That's our goal. I say that ortho parent anxiety, what orthos will say that don't want to do Invisalign is this year.
One, they used to say Invisalign can't handle your case. They really can't honestly say that anymore. Secondly is your kids won't wear the aligners. We see it all the time. Many orthos, though, that are over 65% Invisalign will just say, "Look, if they don't wear their aligners, I know they will. I look at your kid. I look at their dentition. I know they take care of their teeth. They're going to wear their aligners. If they don't, I'll put them in wires and brackets, no charge." Those doctors end up with 80%-90% Invisalign or more that do that. Okay? Those are the doctors who really want to do it overall and not encourage something else. If you look at that previous slide, 85% of the patients want it. That's why we're all still here. It drives us crazy, right? That patients want it.
We know we can do it. We have to reduce that friction and gain doctors' confidence in order to make those critical next steps to grow the business. Direct-to-consumer model, SDC, SmileDirectClub, it's in a rearview mirror now from whatever. That model didn't work. It didn't work because you spend more money advertising than you actually could gain from patients. We did learn a lot from SDC. One, there's a severe price elasticity curve in this business. There's a lot of people who will take digital treatment at certain price levels that we're very cognizant of, and our doctors are cognizant of too. Every conventional dental company that we compete with now have come out with a clear aligner. Okay? My feeling about those clear aligners, they're all substandard. Okay? The software's substandard, the plastic's substandard. Their distribution force is substandard because it's not dedicated.
I'm not talking against them. It's just this is a tough deal to play. Look, I've run conglomerates in my life. I had a big conglomerate at ABB that I came from. Yeah, a lot of different businesses at one time. GE Healthcare is a big conglomerate. When you run a conglomerate, you have to feed a lot of mouths. It's very expensive. You just can't—it takes a lot of money to walk up that 30-year track that I talked about in that third slide. A lot of money. If you want to be good in this industry, you have to invest. I think the conglomerates are not stupid. It's just it's hard to have money to make the investment you need to really drive this industry forward. Single players that are focused on aligners are the ones that I think will do the best.
Secondly, and I'd say the one that we see the most right now, the single-focused players, Angela lign out of China. We know those guys. We've known them in China for years. We're still the number one aligner supplier in China based on revenue and growth. As they come into the marketplace and out of China, you can't scale on the average selling prices that they're moving into the marketplace with. You just can't afford to scale. You can't get into 3D printing. You can't do minute ClinCheck. It just is prohibitive in that sense. There is some kind of a piece with that where at some point in time, you have to have a better product and not just play on price, okay? You have to find a way to scale with this. Again, all these models are tough models.
This industry is not a static industry. Technology is moving all the time, and you have to move with it. We feel we lead that, and we'll continue to lead it. Just to end, I can't overemphasize deep and broad technology, okay? Again, I took a long time on that third slide, and that's what I wanted to get across. Distribution is so critical in this business. It's more critical than any other business I've ever run. Our salespeople are kicking doors down every day. These are individual proprietary businesses of people that aren't business people. They're clinicians. You're talking to them about a whole new way of doing something. The capability of your field force and what you arm them with is one of the most important things that we have to do in this business. Global scale with regional and local touch.
We are a very global business now. We're fully capable in China. From an Asia standpoint, we're fully capable in Europe now with Poland. It pays to be global, and you have to have local touch. Last, brand power for doctors and consumers and patients. We have to keep emphasizing that brand. Remember, that got us as far as we are. We'll continue to drive that. Appreciate your attention with that. I'll introduce Mitra, our favorite orthodontist here at Align. Here you go, Mitra.
Thank you, Joe. Hi, everybody. I'm Dr. Mitra. I've been with Align just coming up here 25 years. I'm super excited to be here with you all today to really talk to you about our clinical leadership and how our clinical leadership really has an advantage and superiority when we look at our innovation, our products, our treatment planning, support, and services. Joe talked about the global opportunity, and that 75% of the population out there has malocclusion. Our vision, as he talked about, is about making tooth movement the standard of care. It's about making that tooth movement through digital. It's the only way to scale. The only way to scale is through clear aligners. It's not only about addressing the aesthetics.
In order to capture the broader market, we need to focus on helping our doctors scale and treating patients that impact as well as the function, the bite, but also the ability to do tooth movement and tooth straightening in cases that could be preventative from helping prevent something in the future for patients. Now, the orthodontic opportunity, as we know, lies in with kids and teens. Our investments in the last few years have been really focused in this area around kids and teens. If you think about what we're doing with our orthodontists, we are partnering with our orthodontists to help them scale their business, their practice for efficiency and profitability while continually delivering those exceptional clear alignments with clear aligners. It really boils down to three key bucket areas.
It's about clinical and clinical superiority, continually showing that we are either on par with delivering clinical outcomes with braces or even superior in many times, having the portfolio to address the full needs clinically for kids and teens, but also bringing education, education to parents and patients around the impact of orthodontics, around the impact of clear aligners for early kids and teens, and really addressing and impacting clear aligner advocacy and addressing the myths around compliance. It is really about helping them scale. What is most critical to their business and what they do every day is treatment planning. That ability to digitally scale that treatment plan. What is important to orthodontists is keeping personalization and control and having that in-the-moment treatment planning. There is a lot of evidence out there around the clinical efficacy of Invisalign.
What puts Align in a unique position is the power of our digital database. We have 20 million smiles like no other clear aligner company has. We have the ability to go in there, machine learn, look at that data. In fact, we just looked at the last two years of data from Vivera Scans, where we had braces finishes and Invisalign finishes. You can see with the sample sizes of hundreds of thousands of cases, we can see equivalent outcomes of braces and Invisalign in the North American population in teenage population. There is no question here in the power of the Align database and the power of the efficacy of the Invisalign clear aligner system. This further validates with hundreds of thousands of sample sizes the Invisalign system.
What the opportunity we have forward is to take this data and now help educate our doctors, but also our consumers on the efficacy of clear aligners. Now, the portfolio is just as important. Joe talked about this. Several years ago, we launched Invisalign First. Very successful product for us, a product that helped us grow globally and has helped adoption for our doctor customers, orthodontic customers globally. Remember, when we talk about kids and teens, it is not only about moving teeth. We need to be able to have a portfolio that moves jaws, that moves the skeleton. Kids and teens are growing. It is that time where we need to help not only do orthodontic tooth movement, but what we call dental facial orthopedic movement, helping them with their jaws and growth.
We need a portfolio, and we've been investing and expanding our portfolio so that we essentially could treat any child and any teen in an orthodontic office, no matter what clinical condition they have, whether they need expansion for permanent teeth, whether they need to bring their lower jaw forward because they're class two, and class two being one of the largest prevalences of malocclusion out there with 45%. A product like MA, and specifically mandibular advancement with occlusal blocks, helps capture this market by allowing not only class two correction, but also if there's class two deep bite and bringing more efficiency for the doctors and treatments. A broad portfolio is important. We also know that as we expand into the kids and teen segment, we need to help educate the parents out there.
Not only educate them about clear aligners, but focus on the clinical needs and benefits of clear aligner therapy, but for early orthodontic treatment. What you'll start to see in market is an example of how, by age seven, your child's teeth should be checked by an orthodontist. Invisalign First expands mouth arches while making space for incoming teeth, straightening teeth precisely, predictably, comfortably. Invisalign First.
Really helping parents understand the clinical need of why they need to see an orthodontist early. Our opportunity here as we move forward is also we're partnering with many societies, with our customer doctors in getting this message out to have children get in early to see an orthodontist and have an orthodontic exam for the future. What we've seen is kids are more compliant than adults with clear aligner therapy. We also know that parents may still be skeptical and have concerns because it's a removable appliance. Despite the many advantages of a removable appliance on the quality of life, on the oral hygiene, parents may still be concerned that patients may not be wearing the aligners. The parents are the same. We live in a world where they're digital, just like the kids are digital.
We have developed tools, and Sree will continue to talk about this and how we provide digital engagement between parents, the treatment, and the kids to help monitor compliance with tools like Invisalign virtual care. We have expanded that not only for monitoring and support, but to allow family sharing so parents can look at multiple kids, give real-time compliance feedback to parents around their child's treatment journey, and also been focused on expanding that product support across our kid and teen portfolio, which is where the impact will be the most moving forward. At the core of what a doctor does and ultimately what every patient needs is a diagnosis and treatment plan. We are a medical device, and in the end, every patient needs a treatment plan. The only way to help an orthodontist scale is to help them scale digital treatment planning.
Over the past years, we've had many building blocks around our ClinCheck software. Joe talked about the journey, and Sree is going to talk a lot about the technology. From a doctor perspective, it's a vision that is now realized really in 2025 with the ClinCheck signature experience. For orthodontists, it's not only about helping them scale digitally on the treatment plan and allowing them to have that personalization and control because every orthodontist is unique. They treatment plan differently. They're distinctive, and every patient is unique. Align really is the only one who has the technology and innovation to be able to automate multiple and hundreds of doctors' clinical preferences so that they can save time in their treatment planning. As we know, as the Invisalign volume increases in a practice, the ClinCheck throughput reaches terminal velocity.
The investments we've made and brought together around this ClinCheck signature experience is really to help our doctors scale the part that is most critical to their practice around digital treatment planning. We continue to provide them with tools like 3D controls, plan editor, or live update so that they can still personalize and control, but give them the time back and help them build capacity so that they can increase more throughput in their practices and help them scale. In a GP practice, the opportunity is different. If you think about a GP practice, the patients and the opportunity lie in the practice and in the chair. Again, 25% of the patients in that practice have the opportunity for tooth alignment or tooth straightening. The partnership we have for our GP customers is different.
It's about how do we help them integrate tooth movement predictably and efficiently in their practice for any type of GP practice that's out there. There's many different ways GPs practice. There are many different types of GP practice. They're not necessarily the most confident or the most proficient around tooth movement. It's how we can help them integrate this tooth movement predictably and efficiently, but also facilitate the concept of comprehensive dentistry through multidisciplinary care. That multidisciplinary care can be ortho-restorative. It could be ortho to it could be referrals to the orthodontist. It could be working in a multi-group practice. If you think about it in a GP practice, it's different. It's about creating relevancy in the GP practice, creating relevancy for the doctor, relevancy for the patient, and they need also a relevant portfolio so that they could treat.
It's about how do we provide, again, treatment planning, a core part of what GPs need to be consistent and predictable as they scale and help them with their clinical confidence through the journey, and then integrating into their workflows, integrating into the workflows of the doctor, but also their staff and how their procedures are working and bring these tools so that we could help them drive profitability in their practice. When you think about a patient population in a GP office, many can be teeth seekers, teeth straightening seekers. They're already actively looking for teeth straightening. They may already be educated about teeth straightening. If you think about our focus around Invisalign outcome simulator, that's where we've focused.
Now, take that, and we've talked to you about that before where you take that, or maybe you've experienced it in the café, is that you take your teeth and you put them into the patient's face, into a smile, that emotional impact that comes, that patient visualization that can help lead to conversion. We see going from a 3D model to integrating the model into the face brings that emotional connection with two times more conversion. There are still a lot of patients in the GP practice who may be unaware of what are the benefits of teeth straightening. There are also many patients in the practice who are unaware of their oral health or uninformed about their oral health.
Bringing these other digital tools onto the iTero scanner, such as Align Oral Health Suite and Align X-ray Insights, allows the GP or any doctor to have those conversations with their patients by showing them the visualization, educating them, and then leading to conversion. Really broadening the type of education and conversion tools that we have to offer for doctors. As I mentioned, portfolio is so critical. Having a portfolio for GPs to address the range of case types and the different types of practice types is critical. Whether they just want to focus on simple tooth movement cases or whether they want to get into complex ortho-restorative procedures, we have the portfolio now so that they could address all these needs.
An area where Želko is going to talk about is also the GP who may not be proficient in tooth movement or who may not even be thinking about tooth movement, who's only focused on restorative for the patient. By their work and partnership with the lab, when they send the cases into the labs, then with their partnership with the lab, there could be a conversation or education about how to integrate tooth movement into their procedures. Just like I mentioned with orthodontists, and really it's for any doctor, diagnosis and treatment planning is so critical. With GPs, it's the same. We're using the same signature experience because it's automated. It helps with digital scale in a practice. What positions us in a unique position with GPs is this concept of templates. Again, Align, we're uniquely positioned.
We've developed an Align template based on our millions of patients, our ability to go in and machine learning. All the clinical protocols that we've developed over the last 25 years, our G series, our predictability, our ability to go in and look at what are the preferences, the most successful preferences or protocols, and build an Align template to help our GPs with the diagnosis and treatment planning aspect and the ability to scale. We also can take this concept of templates and expand that with DSOs. One of the things DSOs look for is consistency and scale. If you're a clinical leader in a DSO office and you have multiple clinicians, you want to be able to treatment plan in a consistent and predictable manner. This concept of templates will also help practices like DSOs further scale.
It's about bringing in the GP practice confidence and consistency around treatment planning for them. Just as we know products and services are important, they're not just the only thing that matters. It also matters that we provide and we surround our doctors with the support. That support needs to match whatever doctor need or style that is. We understand that more than anyone else at Align in how to take our programs, our go-to-market strategies, our education pathways and journeys, and really segment that for our different customer segments and look at how we could support and match the needs of the doctor, where and how that they want that.
If you think about Align and our unique position, we have the clinically proven results across our portfolio, whether it's treat simple cases, complex cases, dental, skeletal, the clinical evidence, and in the hundreds of thousands that we're also seeing is there. It's about taking that and surrounding that with our Align digital platform that helps patients to help drive conversions with patients through tools like visualization education, helping doctors scale the treatment planning, and really bringing that integration into their workflow with the different tools. With that, I'm going to call and invite Sree here to further talk to you about this Align digital platform and the technology behind it. Thank you.
Thanks, Mitra. It's great to see all of you. I'm going to start talking about how software powers all the products and services we build out to make teeth movement the standard of care in comprehensive dentistry. We also have a suite of solutions for orthodontists, starting from teeth straightening to retention and peer-to-peer treatment planning support that Simon will refer to and the impact it's having with diagnostics and retention solutions with iTero. We are working on very highly relevant products for GPs. Underlying all the software is very high-quality data. We have different sources. We have from X-rays, photos, scans, NIRI images, CBCTs, and we continue to add more. What happens is when a patient's journey starts with the iTero scan, it's that moment where raw anatomy becomes structured digital data. Every scan, every treatment, every outcome will continue to feed into the Align data ecosystem.
No one else has as much data in a closed-loop format that is starting with a scan to simulation to treatments to outcomes. All of this high-quality data enables us to do continuous AI machine learning modeling. It gives us great insights that help develop products so that we can deliver exceptional clinical outcomes. We can deliver for practice growth and profitability to the doctors and also put tools in doctors' hands so they can deliver great digital experiences to their patients in the practices. When we look at awareness of the product, all our marketing spend goes towards tooth straightening and the awareness around it and Invisalign as a brand so that when patients go to the doctor's offices, they understand the treatments they're going to get. What we do is we use science-based media planning with Meta, with YouTube, with TikTok.
We are reaching the right audience at the right time. We are also creating compelling stories with influencers and real people telling real stories so that for growing patients, Invisalign is the brand of their choice. All of us are consumers today. If you look at our own patterns of how we engage digitally, we are scrolling, streaming, searching, shopping seamlessly between platforms. What we are doing is we are working with Google and their AI to ensure that we have the right message in the right format at the right time with the right audience so that consumers can recognize what Invisalign and tooth straightening can do. The results show the billions of views that we are able to generate and also engagement in apps like My Invisalign that patients use where we have 5 million downloads. 400,000 patients use that app monthly.
We are continuing to use this to build more and more digital doctor and patient engagement apps. We'll continue to innovate on the platform. Now the patient is in the doctor's office. Lumina is not just a scanner. It's an imaging platform that allows us to build out lots of different kinds of apps with high-quality scans and images. We are starting with diagnostics. We all go to doctor's offices. We all have our hygiene appointments. Invariably, the staff, as well as a doctor, is trying to explain to us, "We have a filling here. We need a crown there. If you don't do anything about it, you're going to get a root canal." I just sort of roll my eyes. I'll say, "I'll go home and come back and call you," which never happens.
Imagine if you are in the doctor's office and we have AI-based diagnostics and X-rays, and the doctor is showing you what the implications are of not taking care of your oral health, and then also sends you home with an automated patient report, you are more likely to take action. We are integrating it with the Align Oral Health Suite so that the combination of X-ray data and the scan data and the NIRI images, we're just starting the journey. There is a lot to come, innovation that and AI is made for this type of data and diagnosis in doctors' hands. You can see the patient engagement is 100%. All of this means that the doctor is able to increase their practice revenue and also gain more patient treatment acceptances.
Another conversion tool we have is the Outcome Simulator Pro that shows the before and after. We have now enhanced it with the video. If you have not experienced it in the café outside, I highly encourage all of you to go see yourself and the before and the after in real time, in real form, and how that emotionally changes the patient to wanting to get the treatment right there, chair side in the doctor's office. We have taken it a step further, and we are showing doctors multiple treatment plan options. The doctor not only shows what an orthodontic treatment could look like, but if it is really applicable, they will also show what a minimally invasive orthorestorative treatment looks like that protects the healthy teeth.
The patient and the doctor are able to have real-time communication that is visual, chair side, that is giving more tools in doctors' hands to gain patient acceptances right there. As we move into treatment planning, we know that this is a journey that we have been on since the beginning of time. Where we are right now is we have the ability for every doctor to create an Invisalign personalized plan. We have introduced global templates that Mitra just talked about from the 20 million smiles and the insights that we've gotten from that.
The doctor also has several tools like the Live Update and the Plan Editor for more complicated treatments that the doctor wants to do chair side when the patient is in the chair, live in the moment so that they can remember what the patient's clinical conditions are and how to treat them. This process used to take several days and is now down to minutes. The doctors are telling us about how much it has improved practice efficiency, patient communication, has allowed them to change their workflows to ensure that they are able to gain patient acceptances. All of the real-time visualization and the ability to engage with the patient about what the treatment plan could look like is all now available in the doctor's hands. This has been a very, very long journey.
I remember a similar time 20 years ago, a bunch of us engineers were trying to write code just to do two things: to take ClinCheck from a one-page static view, to be able to show the movie off the treatment plan, to be able to keep machines up in the data center as doctors were trying to understand what the plan could look like. We were trying to imagine what the communication between the doctors and CAD technicians should look like in a very static back-and-forth web form. You fast forward 20 years, and we look at what we have been able to release just in the last five. We can do ClinChecks on the Mac. We can do ClinChecks on mobile. If the doctors wanted to do it on the beach, go for it. We are able to visualize routes.
We are able to set up treatment plans. Also, for doctors to finesse all these movements live has taken hundreds of engineers, 20 million smile data, thousands of insights from our CAD technicians, the convergence of cloud computing, of machine learning models, and very high-quality data scans that are coming out and even better with Lumina. All of that has converged, and we have been able to provide just so much innovation in the last five years that doctors are now able to provide ClinCheck in minutes live as the patient is in the practice.
When we combine this power of what AI can do in truly personalizing the doctor's preferences and all of the dentitions that are available in the world, the billions of them, and what Sree is going to talk about next in terms of what direct fab can provide and customizing appliance tooth by tooth, the power is so large that we are barely scratching the surface of what's possible. I cannot even begin to imagine what the next five years are going to bring in terms of the products that we're going to build out that will drive exceptional clinical outcomes, that will drive great patient experiences, that will deliver practice growth and profitability for the doctors. As we move on from treatment planning, we have also been introducing a lot of tools around virtual care and with AI.
We want to ensure that patients are taking great pictures with the lens. We have a lot of workflow tools that we are building out so the doctors and the patients can stay in touch. AI has helped quite a bit in ensuring that we are tracking ClinCheck to plan. What we've been able to do with growing patients is the parents' anxiety around the compliance of kids. We are now introducing AI for monitoring across all aspects of the products that we are through the growing patients' portfolio. The doctors and the parents and the patients can all stay in touch through the course of the treatment and will hopefully get comfortable. We get a lot of great data in that doctors feel like they are able to provide as much engagement with their parents and the patients as they would in their own offices.
It also not only helps them stay connected, it is also improving their confidence about how the treatments are tracking, which will also improve how often patients feel about requiring less and less in-office visits. With all of that hard work in building awareness around tooth straightening, treatment planning, getting your treatments monitored, making sure they're tracking on time, we want to ensure that your smiles stay for life. We are building out products which are easy to use that are in the same platform with the practice app and the My Invisalign app that doctors are able to provide subscription options for Vivera. The patients can choose what options they like. It is very user-friendly. We are also able to provide this opportunity for patients with braces.
If not for AI and the ability to detect braces at scale, this would not have been possible. It is a lot of complex technology that we are using to make the product very simple for the doctors to prescribe and for the patients to use. In the end, we know that as all of the connected data and the connected workflows and all of the stakeholders, doctors, patients, consumers, labs, staff, all of them come together on the same platform, we have to earn the trust every day by ensuring that the data is safe, the data is stable, we are using the models responsibly. What keeps me up at night is the excitement of what the convergence of technologies can do with AI, hyperscale computing, and what Sree is going to come and talk next about what direct fab can do. We are just getting started. With that, I'm going to introduce Sree to talk about direct fab.
Hi there. Thank you for having me here. In the next 10 minutes or so, I'm going to talk through, I'm hoping to convey two main things to you through my presentation. One is that Invisalign is still the best product in the market by quite a bit. It's still the best product in the market. Second, innovation-wise, that we're still the most innovative company in the world and innovations that matter, innovations that scale, that deliver the right amount of performance to our doctors and to our patients. Hopefully, I can convey those two points as we go through these slides.
Really, what I'm going to talk about is innovation at scale, kind of how we take innovations to solve key problems for our customers and how we're able to deliver it on a consistent basis at a massive scale. That's really what we're trying to do, to Joe's point, kind of making 2 million unique devices every day that can precisely provide the right outcomes for our doctors and our patients. That's really what we've been doing over the years and what we'll continue to do as I talk about direct printing and so on. If I kind of take a look back at kind of where we've come from over the years, again, Joe and others talked a little bit about it previously. I would say there's probably two main points for you to think about. One is orthodontics is very materials.
It's very kind of centric on materials. Having really high-performing polymers that can deliver the right outcome, otherwise, none of the other stuff matters because whatever you design, you need to be able to deliver it in the patient's mouth. SmartTrack is that material that can deliver it. We're not done with that, by the way. We keep innovating on polymer science. Polymer science is at the core of a lot of things that we do. It took us years and hundreds of materials, hundreds of different combinations before we came up with SmartTrack. That's sort of what I'm trying to show in this timeline. It is really by far the best-performing material out there. We know a lot of people have tried to copy it. Nobody has been able to do that.
That's because of a lot of kind of the core fundamentals that we apply to polymer science. Once you have that, you kind of synchronize that with a lot of the other things. Joe talked a little bit about loading the aligner. We call it activation. How do you activate this aligner to get it's not just what you see from start to finish, but how do you get from start to finish, kind of being able to deliver those four systems, being able to activate the aligner at the right spots, again, at a massive scale. It's not enough if you show it on a couple of things in the lab. You've got to be able to do it at a massive scale. How you move teeth. Kind of those three together, you start with the core.
You've got to be able to deliver that performance. Then you can layer in all these design tools on top. That's really kind of the journey that we've come over the years. Mitra talked about the wide portfolio. We kind of use the same principle for every phase of this. Every device that we design and deliver to the market, it's the same principle. Got to solve a key problem, highly innovative, but it's got to deliver consistently over a massive scale over and over again. That's really what I believe we're really good at and how we differentiate ourselves in the market and why we're the best product out there. Mitra talked a little bit about Invisalign First. We see great results from Invisalign First. It's one of our fastest-growing products.
What I would tell you is it's not by accident that doctors are seeing great results. It's not something that can be reproduced. We've taken care of a lot of things in the background. Here are a couple of examples that I'm showing here. A most common thing that doctors do with Invisalign First is dental expansion. Basically, expand the teeth so you allow your unerupted teeth to come in into the arch. There are a lot of mechanical principles behind it, which I won't get into. Taking care of that in six dimensions, really, so teeth move in six dimensions, taking care of all those force systems so you can consistently get great expansion. Every time you program expansion, consistency gets that great expansion.
At the same time, when you start expanding, there are some unwanted movements that can happen, like the molars can start tipping and so on. Taking care of those unwanted forces and balancing those two in six dimensions and consistently delivering it aligner to aligner. That is really why we see these great results that our doctors show all the time, the great expansions, great outcomes, and so on. It is really a great example of how the design, if you have the right design, the right material, and the right force systems, you can deliver great outcomes. The second example I am going to talk about is Class II correction. Roughly somewhere between 30%-40% of cases present with Class II, very common treatment in a doctor's office. We have the solutions that I am showing on the left and the right.
We have the precision cuts that allow the doctors to use elastics in some cases to treat Class II. We have the enhanced precision ring solution that doctors use to deliver that. I'll talk a little bit about the one in the middle that we've just introduced into the market. I mean, this is an example from one of our doctors about how they're using these Class II solutions to create great outcomes. Class II is when your lower jaw is too far back, you're trying to correct that. It is a combination of skeletal. Some people do it skeletally. Some people do it dentally. Here, you're seeing a skeletal correction, fantastic skeletal correction that's achieved using EPW. Now we're trying to kind of take it to the next level with occlusal blocks. That's really the solution we've introduced in the market.
There's probably two things I'll tell you here. One is the blocks. If you look at the blocks, you'll notice that they're solid. They're solid for a reason, which I'll talk about real quick. There's a high factor of safety. These things have been tested for hundreds of thousands of cycles to deliver the right, again, deliver the right four systems, the right design consistently over millions of devices. The reason why these blocks are solid is if you look at kind of the performance of a hollow block, the problem is when it's hollow, it's just physics. When you have blocks that are hollow, patients will bite on it, and they'll start deforming. I'm just showing three cycles here where the blocks start deforming already.
Imagine over a treatment of time, maybe for a small % of cases, it might work because the patient's not biting too hard. There is a large % of cases where they will not work because the blocks start deforming. When they deform, you will not be able to apply the right skeletal force system. That is really what we have solved with these occlusal blocks. They are solid, again, tested over hundreds of thousands of cycles. Once you design the right way, deliver it over millions of appliances, you get great results. Clinically, that is what we are seeing. We are seeing some fantastic results from our doctors already, which hopefully we will start publishing soon. Now I am going to switch gears a little bit to direct printing. A lot of work is going on around 3D printing, but the same core principles.
You've got to have the right polymer to start with. We work with every major chemical company out there in the world, all the large chemical companies, to try and partner and deliver these polymers. To the point Joe made earlier, there is nothing out there in the world that can deliver these high-performance polymers with the right balance. Regardless of the noise you see out there in the market, that balance simply does not exist. This is a lot of things that we had to invent, not because it was fun to do it, but because we had to do it to be able to get to that core. You need the right polymer. Then you can start building all these other four systems and all that stuff, and you can deliver great appliances. First example of that is palatal expander.
It is already out in the market. Again, same principle. We have the 3D printing process that can deliver these designs. We have a great design, which I will not have time to talk about today, to try and balance the skeletal forces to get the skeletal correction. You deliver it consistently thousands and thousands of times using these appliances. What we see is the great results we see on the right. This is not just me saying it. A lot of our doctors are showing it. There are papers being published showing very, very high efficacy. It is almost 100% in terms of efficacy. It kind of validates that model that you designed it the right way, deliver it the right way. You are going to get great results. We are going to continue building on that platform.
Last time I was here, I talked about our Cubicure acquisition. Cubicure is a very critical piece in terms of how we deliver these polymers into a printed model. We are working very hard. Every project that we talked about last time, we are working hard on them. I just want to show you a quick video showing some of the work that we are doing on these printers and how we are printing these devices. Play the video, please. OK, this is where I start dancing to the music. This is kind of my last point on the devices. Last time we were here, Joe talked about the fact that we are going to go into a pilot with some of these devices. We are in a pilot. We have patients wearing these devices.
The first product that we're scaling to introduce into the market is a retainer product, highly customized, putting the full customization and design power into the hands of our doctors and being able to deliver it consistently. Retainers is in pilot right now. We're trying to scale it. We're also working on aligners. That's also in pilot. Hopefully, we can start talking about that down the road. Again, design it the right way, deliver it the right way. We believe we're going to get great results that's going to further differentiate ourselves from anyone else out there in the market. With that, I'm going to pass it on to Emory. He'll talk a little bit about scaling these 3D printing technologies. Thank you.
Our direct fabrication 3D printing, especially in the clear aligner space, and more recently, it's been obviously around for quite a while.
A lot of that information typically lacks context. Oftentimes, it can be kind of confusing. Sometimes, I think it's actually misleading. I wanted to start by just providing a little bit of kind of context for 3D printing in the clear aligner space and then get into our direct fab platform and kind of where that's going. OK, there are two ways to make aligners using 3D printing. One is the indirect way, which is the top figure there. That's what everybody does, including us. The other way is the direct way, which is something that I would say is futuristic. In the direct, you have a resin in a 3D printer. You print a model of a stage of treatment where the patient's teeth are for that stage. You have a liner material that you form on top of that model.
You trim that off of the model. The model gets thrown away. You post-process that aligner and you package it and ship it. That's the indirect method. I've been involved with this process for, like I said, a little over 25 years. We are the best in the world at this process. We have the largest scale by magnitude. We have the most efficient process. We produce the highest quality aligners. Having said that, the real secret sauce in this process is the aligner material and the biomechanics that's designed into every stage of that treatment. Sree talked a lot about that. That's what makes this system work. We're also best in class in those two things. You don't have to take my word for it. You can talk to customers that have gone to competition and used a product for a lower price.
They come back to our business. They'll tell you it's because the other guy's aligners don't finish cases. They don't move teeth predictably. There's a lot of evidence out there. We spent a lot of time. Joe talked about this, a lot of money developing this process. It's highly efficient. It's our workhorse for the company now, for sure, and in the foreseeable future. It will continue to exist. Now on to direct printing. Direct printing, you have your material. Sree talked about that. We have a printer. Sree also talked about that. You'll notice that there's no model that you have to create. There's also no aligner material. You just directly print the appliance. There is a degree of post-processing that's not insignificant that's important. That's that process. Technically, it's not hard to 3D print an aligner.
We've been able to do it for decades. The issue is that the materials and the printers that are available in the market don't produce an aligner that has the mechanical properties that can actually move teeth predictably. There have been a few announcements recently of companies that have direct-printed shape memory aligners. That's what they say. They're using materials that leverage existing printers. We've tested the heck out of that. We know that the resulting aligners don't move teeth predictably. They even kind of say that in their own marketing material if you read between the lines. It is kind of rolled into this shape memory story that's also not true.
Really, when you look at the secret sauce of this process in order to directly print an aligner that can move teeth predictably, you not only need the material and the biomechanics, but you also need the printer. Align now has all of that. We own all of that. We've vertically integrated that under our umbrella. We think that that system will provide some substantial benefits above the indirect method. Both of those methods are still very critical to Align in the future. I just want to make that point. OK, Joe talked a lot about Align's innovations over time, over the past almost 30 years. I think it's important just to remind ourselves on specifically our capability on 3D printing. We've been at it for almost 30 years. We've pioneered it for almost 30 years.
We're the first to take a prototyping technology, which largely today, 3D printing is still a prototype technology. People don't use it the way we use it. We've turned it into a true mass customized manufacturing platform. We've built and maintained and continue to recruit the best talent in 3D printing, not just the printer and 3D printing, but software-related software and other engineering disciplines that are required to kind of do that end-to-end process. We continue to push the industry beyond what the industry thinks is possible. To Sree's point, a lot of things we need to invent internally. Other people can't do it. With our material science that Sree talked about and our recent acquisition of Cubicure, we now kind of have a force multiplier from a competitive advantage standpoint with 3D printing.
With that as a background, what are we going to do with this new 3D printing platform, which is probably a question you have? There are three use cases. These are more or less the chronological order we see them coming to market. One is printing devices that cannot be done with the indirect method. These are things that the design freedom we have, the ability to design in very specific features, the accuracy and control we have of this allows us to make things like a multi-featured retainer. Today, you can only buy in separate devices on the market. We could do it kind of all in one. Also, things like our prefab detachment that will drive productivity in the doctor's offices. Those are things that are in market right now at lower volume.
We'll scale those up as our commercial and regulatory timelines predict. That's the first use case. Like I said, we're in market. The next use case will be to be able to make existing devices work better. That's things like occlusal blocks Sree brought up. There's a desire from our customer base to actually make a dynamic block size. This helps to close the bite. It's difficult to do indirectly. Direct printing, that's a perfect application for that, making that block stiffer so that it actually withstands the hardest or the people who chew on these things the most, things like that. Aligners. There's the opportunity for us, again, using the design freedom that we have to address some difficult movements and make that aligner work better, integrate that into the Invisalign case, and actually have better outcomes or more predictable outcomes from that case.
Longer term, as we scale this direct fab technology we have, it can become a manufacturing platform substitution. This could be at a lower cost, less waste. You saw in the previous slides where you throw the mold away. Some of that aligner material Joe talked about goes away. This does not have that same kind of waste profile. As we scale, this could be the next manufacturing platform. For the foreseeable future, these things are going to coexist together and in a symbiotic way. I know cost is top of mind with you all here. It certainly is for us within the company. I think a lot of people are kind of wondering, well, what kind of cost leverage will this new direct fab platform provide?
We think that you see on the slide here, there's kind of our top four cost drivers for Invisalign. We think that on the material side, there's significant room there. Again, there's less waste. As we scale the material and are able to make that less expensive, and then obviously, as we scale this process, we'll be able to take costs out there. The other thing that we believe is that this platform will allow us to, in a cost-effective way, get closer geographically to our customers, which will then allow us to reduce our freight cost, which is another one of our big drivers. For sure, as we get better at this, as we've shown with the indirect method, we'll pull costs out of all these cost drivers.
Those are kind of the two big ones that we think we're going to have a big impact on going forward. Where are we going to go with this thing? What's the path forward? We're going to continue to work on solving the scalability opportunities we have around the material, around yield, throughput, things of that nature. Our experience helps tremendously here. We know what to look for. We have line of sight for these improvements. This is, as Joe likes to say, time and distance for us. Time might not be linear. We know what to do here. We're confident we'll get these opportunities taken care of. How you'll see it, I mentioned it before. You're going to see it in new devices first. You're going to see it in better devices and then as a replacement manufacturing technology.
I guess the questions are like, well, where are you going to put this new technology? It'll start in our San Jose campus and in our factory in Mexico, largely because that's where we have the best access to talent and control of that technology as we scale it up and make sure that it's ready for prime time. Then we will move it into our other factories as that makes sense strategically or cost-wise. In longer term, I think it's possible for this technology to be able to be more local in local markets. Again, I mentioned that about freight, but also responsiveness to customers and a way to kind of speed up that cycle. That's kind of our path forward, how you should think about how this direct fab technology, how we're going to leverage it. That is it for me.
Thank you for your time. Srini's going to come up here and talk about the rest of the day.
OK, great. Thanks very much, everyone. We're going to take a very quick break, 10 minutes, please. I know we're a little bit behind on our schedule. When we come back, we want to show you in practice, one of our doctor's practices, how this technology all comes together. Dr. David Galler, many of you know, is a local, original native New Yorker, general practitioner, dentist, has trained thousands of Invisalign doctors, has done and treated thousands of Invisalign cases. We're going to share a really great video with you when you come back, grab a cup of coffee, get comfortable. It's a great opportunity to see firsthand what this looks like in practice. The video was filmed prior to some of this really great innovation on the iTero Lumina scanner coming to market and some of the other innovations.
Just keep that in mind as you watch it. Please go ahead for break for 10 minutes. We will come back at 11:42, 11:42. Thank you, everyone.
I've been up, I've been down, seen the world from the ground. I hear the drumming. Now my veins are pumping. Scrape my knees, bruise my heart. Where you end, not where you start. I see them running because they see me coming. I'm done with the noise, the losses of pain. I'll use my voice, my tune to sing. You know that all my life, I have been waiting. I have been waiting for this. All my life, I have been fighting. I have been fighting for this. Dreaming my soul, and I won't let it go. You know that all my life, they try to keep me down, but I just get higher.
They try to keep me down, but I just get higher. Broke my bones, tasted blood, burned my wings close to the sun. But I keep on flying. I'm too young for dying because there's a dream I can taste. Think it's time I break my chains and run with the giants. Lots more come rising. I'm done with the noise, the losses of pain. But I'll use my voice, my tune to sing. You know that all my life, I have been waiting. I have been waiting for this. All my life, I have been fighting. I have been fighting for this. Dreaming my soul, and I won't let it go. You know that all my life, they try to keep me down, but I just get higher. They try to keep me down, but I just get higher.
They try to keep me down, but I just get higher. All my life, all my life. There's a dream in my soul, and I won't let it go. You know that all my life, they try to keep me down, but I just get higher. They try to keep me down, but I just get higher. They try to keep me down, but I just get higher. Running through the strange lab, chasing all them green lights, throwing up the shade for a little bit of sunshine, hit me with them good vibes, pictures on my phone live, everything is so fine, a little bit of sunshine. Crazy lately, I'm confirming, trying to write myself a sermon. You just trying to get a word, and life is not fair.
I've been working on my tunnel vision, trying to get a new prescription, taking swings and even missing, but I don't care. I'm dancing more, just a little bit, breathing more, just a little bit, caring less, just a little bit, like life is woo-hoo. Now I'm aching more, just a little bit, spin a little more, take a bit of it, smile a little more, and I'm in it with, I've been running through the strange lab, chasing all them green lights, throwing up the shade, for a little bit of sunshine, hit me with them good vibes, pictures on my phone live, everything is so fine, a little bit of sunshine. A little bit of sunshine. Yeah, a little bit of sunshine. Another day, another selfish moment. I've been feeling helpless, sick of seeing all the selfies. Now I don't care.
Found myself a new vocation, calibrated motivation, almost out of change of station, headed somewhere. I'm dancing more, just a little bit, breathing more, just a little bit, caring less, just a little bit, like life is woo-hoo. Now I'm aching more, just a little bit, spin a little more, take a bit of it, smile a little more, and I'm in it with, honestly, man, lately I've been running through the strange lab, chasing all them green lights, throwing up the shade, for a little bit of sunshine, hit me with them good vibes, pictures on my phone live, everything is so fine, a little bit of sunshine. A little bit of sunshine. A little bit of sunshine. I don't really know any other way to say this. Can't slow down, trying to keep up with the changes. Punch that number and the name when it's clocking.
Now I feel like Michael with the cane when I'm walking. Basically, life is the same thing unless you don't want the same thing. Probably should have went and got a PJ, but I didn't. I've been saving up the money because it's better for the business. I've been running through the strange lab, chasing all them green lights, throwing up the shade, for a little bit of sunshine. Yeah. A little bit of sunshine. A little bit of sunshine. Hey, yo, big wave. Tell that mic on. Small time alongside JW. My bestie and your bestie sit down by the fire. Your bestie says she wants parties, so can we make these flames go higher? Talking about hair now, hair now, hair now, hair now. Aiko, Aikoane, Chocemofina, Anane, Chocemofinane. Start my truck, let's all jump in. Here we go together. Nice cool breeze with big palm trees.
I'll tell you life don't get no better. Talking about hair now, hair now, hair now, hair now. Aiko, Aiko ane, Chocemo fina, anane, Chocemo finane. I'll play your mama n'gue'le step on the dancing floor. Hips be winding, DJ rewinding, take it to the island way. Get your baby mama, put on your dancing shoes. One drop, it pop it low now, take it to the max now. Jump in this small jam way. Jump in this small jam way. My bestie and your bestie dancing by the fire. Your bestie says she wants parties, so can we make these flames go higher? Talking about hair now, hair now, hair now. Aiko, Aiko ane, Chocemo fina, anane, Chocemo finane. Let me take it from here. Salam and girls straight up, right hoochie mama. Make we party non-stop in an island banda. Swing those hips and back it up to me, raga.
I turn speed party ladies with the doggy doggy. I'm jumping island reggae, ripping blue, green, and yellow. Me jumping and baby making slow wine for me, baby. Speakers pumping, people jumping. We jump in the island way. Shout out to the good time crew all across the islands. Grab your shoes, let me two by two, and then we shining bright like diamonds. Talking about hair now, hair now, hair now. Aiko, Aikoane, Chocemofina, Anane, Chocemofinane. Yes, one drop, it pop it low now. Take it to the max now. I'm jumping the small jam way. Wind it. Wind up, go down, wind up, go down. Twist your body backwards. We go, we go. We go, we go, we go, we go, we go, right, right. Turn it around and forward. Wind it, go down again. Wind up, go down, wind up, go down. Twist your body backwards.
We go, we go, we go, right, right. Turn it around and forward. My bestie and your bestie dancing by the fire. Your bestie says she wants parties, so can we make these flames go higher? Talking about hair now, hair now, hair now. Aiko, Aikoane, Chocemofina, Anane, Chocemofinane. Chocemofinane, Chocemofinane, Chocemofinane. It's always a good time. It's always a good time. Woke up on the right side of the bed. What's up with this print song inside my head? Hands up if you're down to get down tonight, 'cause it's always a good time. Slept in all my clothes like I didn't care. Hopped into a cab, take me anywhere. I'm in if you're down to get down tonight, 'cause it's always a good time. Good morning and good night. I wake up at twelve o'clock. It's gonna be alright. We don't even have to try.
It's always a good time. It's always a good time. We don't even have to try. It's always a good time. Good time. It's always a good time. Take down, drop my phone in the pool again. Check out of my room, hit the.
Okay. Welcome back, everyone. Grab a cup of coffee, a snack, get comfortable, take a seat. We're going to show you a really cool video of Dr. David Galler right now. It really showcases in practice how these tools come together. Without further ado, let's roll the video.
My name is David Galler. I'm going to transform the way your practice runs. For the rest of your dental Invisalign careers, nothing will be the same. Two things we're looking for in the Invisalign game now. Number one, the highest level clinical outcome. Number two, maximum convenience for patients and doctors.
Would you like to see what this looks like? It is 11:00 A.M. on a Thursday morning, and I'm in my office. Two of my millennials have already called out, and we're on to the day. Ordinarily, that would bother me, but not this time because I'm using technology today, and we're going to use technology to treat our patients. Here I have an Invisalign consult coming in at 11:00. She's already had a Panorex taken, and I can see the Panorex on my screen right here, and it looks good. Now she's getting an iTero scan done with the 5D Plus. After we have the scan, then my Invisalign treatment coordinator, Kylie, is going to use something called the Invisalign Practice app. She's going to take a series of nine photos of my patient right there.
She's going to input the patient information in, and it's going to go straight to the Invisalign doctor site. I'm going to have the patient information and all the photos right there on my site. That takes about five minutes to go. We have already done 11:00 to 11:05. We have done a scan 11:05 to 11:10, and we have all the photos in. Now it's 11:10, and time for me to meet the patient. How are you? Welcome to my practice. I'd like to show you a little bit about your teeth. The first thing I'm going to show you is something that I call the NIRI. This is the near-infrared technology. It's a way that I can look into your teeth and see whether you have class two incipient caries or not. We do not have to take bite wings anymore, and I already took a Panorex.
Now I could just use this to show you what's going on in your teeth. Now I'm going to use something called the viewer. Let's take a look at your whole mouth. I know it's not as good as when I'm just leaning over you looking at it. Let's look at it together. Let's figure out what's going on in your mouth. How are these teeth doing? Let's take a look at all the different teeth, and we can move it in different directions. We're looking for abfractions, wear facets, fractures, anything that will tell us the story of your mouth. We're looking for any teeth that might be malaligned, teeth that don't fit into the right spot, and how that might be impacting your overall health involving your perio, your teeth, possibly even your TMD. I'm going to use this little tool.
This is called the occlusal gram, and although not diagnostic, it does show us a heat-seeking map of where you're biting down. If I see spots over here like this red, that means you're biting down a little too hard here, and maybe we should move those teeth out of the traumatic spot that they're in. You know, there are a couple of teeth here that aren't straight, and I'd like to kind of show you what it would look like if we straighten your teeth. I am going to use something called the outcome simulator. This is what you're going to look like if you allow me to straighten your teeth. Look at how beautifully aligned those teeth are. See how the upper and lower teeth connect in such a healthy manner. Now my favorite part.
Because we used the Invisalign Practice app and we took something called the wide smile photo, now with a few clicks on the screen here that you could see behind me, I'm going to create something called the outcome simulator pro. This is a picture, a mock-up showing the patient what they're going to look like at the end of treatment. This is a fake photo. She just came in five minutes ago. Here's how she looks now. Here's how she's going to look afterwards. How do you like the way that looks? I drop the key line. Kylie, she looks happier here. What do you say? Would you like to do some Invisalign treatment? Absolutely. Nobody says no to the goat. Let's mark this occasion, shall we? Starting Invisalign treatment, taking care for your health. Here we go, everybody. Let's smile. Smile. First visit.
All right. Now, my patient's going to go across to the front desk, and she's going to make financial payment arrangements. Meanwhile, I'm going to go to my desk over here, and I'm going to fill out the prescription for Invisalign. Now, years ago, it's 11:30 on the clock. Years ago, the prescription used to take hours. You had to do so many different things: hook up photos, hook up cameras, hook up scanners, take PVS and boxes. Now, it's a few clicks. Now I'm using something called FlexRx. It is a modified prescription where I only have to answer three questions. Three clicks. I hit accept. We upload the photos automatically. They're there. I attach the scan, and in 90 seconds now, I can have this prescription all the way on its way to Invisalign. I'm going to go watch my sons play some baseball. Oh, hey. iPad.
I just got a notification. Guess what? The ClinCheck is ready because I'm using something called IPE, Invisalign Personal Preference Plan, which means that I have an algorithm at Invisalign, and I can pull up the ClinCheck at any time. I don't have a tech who makes my ClinCheck. I'm using a technology algorithm. An hour, 11:30 to 12:30, is not only possible, I do it all the time. Now I have the ClinCheck here, and I'm going to make a couple of changes. I'm going to be using two tools, one called 3D Controls and the other one called Live Update, because even after my own algorithm, sometimes I like to put a little nuance into some of these cases. I can hit Live Update, and I get the new ClinCheck back. Back in the day, I used to make changes.
It would go back to Costa Rica. One or two days later, I would get the ClinCheck back. I have the finished ClinCheck right here. I am going to go ahead. You are going to watch this in real time, and I am going to hit accept. This ClinCheck is already being manufactured. That is how fast the game can be. Two hours, two hours from the time the patient came into the office till the time I have the aligners being manufactured. This is not the future. This is not some wish list. This happens right now. I do this all the time. It is now September the 14th, and my patient is back, and I have aligners in seven days. We advertise aligners in seven days because we are utilizing all the technology tools.
My patient is here, and my Invisalign treatment coordinator is putting them in, teaching them how to use them and how to take care of them. We do one more very cool trick that you probably don't know about. We use something called the lens. The lens is a little attachment that goes onto a cell phone, and it allows the patient to take remote photos of themselves because this is what we're going to be using for the next 17 weeks. On this visit right here, I teach the patient how to use it, and they could do it. Everyone looking good? Good. Visit number two is in the back. Thanks so much. I'll see you next Thursday, virtually. She, patient, leaves the office. Visit number two.
Next Thursday, September 21st, she's going to use that lens, and she's going to use another project called the My Invisalign app, which is a patient-facing app. From the comforts of her own home, she's going to take a series of nine photographs with that lens, which is incredibly easy to do for anybody. She's going to push send. Those photos now go to me on my Invisalign doctor site. I could be anywhere in the world. I could be in my office. I could be at home. I could be anywhere. Clicks up. I look at her nine photos. They look good to me. I send her a text message that says, "Hey, everything's looking really good. Switch to number two." Next week, she takes another set of nine photos and sends it to me again.
Next week, September 28th, I take a look at those. This time, I don't like the way lateral's tracking, so I send another note saying, "Hey, let's wear that a little bit more, get a little bit more munchy chewy action." We do this dance for 17 weeks. The Invisalign virtual care lets me see the patient every week. I'm interacting with the patient every week. If the patient knows I'm going to be watching it every week, they wear the trays. Compliance is up. Additional aligners are down, and profitability is up. Seventeen weeks go by, and now my patient is here for the final visit. I already know everything's going to be okay. How do I know that? I've watched you every Thursday night for the last 17 weeks.
By the time she comes in to get her Vivera retainers, I already know that her teeth are perfect and fitting well, and I could just come in and just be the hero. How'd it go? Amazing. You look incredible. Three visits. Holy cow. Let's take a selfie. Instagram this thing. Awesome. Thank you very much for being a part of Invisalign Dr. Galler's office. That's the game I play at now. That's the level of game that some of us are playing at. This is the first time it's all come together. If you're an Invisalign dentist in the room, there has never been a better time to be an Invisalign dentist. High-level clinical outcomes and maximum patient and doctor convenience. Hey, let's make this easy for you. Let's make this easy for me.
Two hours from the time I have the consult till the time Juarez is starting to manufacture. Seventeen weeks. Pictures every week. No refinement, no mid-course correction, no posterior open bites. Thirty pieces of the puzzle all coming together to create the most perfect digital workflow with the highest level clinical outcome and the maximum patient and doctor convenience. Thank you very much.
Please welcome Karim Boussebba.
All right. What a tough act to follow. Good afternoon. Good afternoon to all of you, and welcome to our Investor Day. It's a pleasure for me to be here and to talk about iTero. Now, the theme of my slides, driving growth through continued innovation. It has double meaning. It's driving growth for our customers. And while doing that, we're driving growth for Align. Now, let me put it in the context of our overall vision, Align vision.
As part of the Align vision of transforming smiles and changing lives, iTero plays a crucial role in delivering innovations, delivering solutions to our customers that solve their needs and their critical challenges, especially in a time where things are getting more and more complex and where our customers and their dental practices have to deal with so many things at the same time. Our job is to make their life simpler. As Joel mentioned earlier, we are obviously looking at the GP segment in a more prominent way. Sorry. Yeah. Thank you. We are looking at the GP segment in a more prominent way because it is an untapped and growing opportunity for all of us. The way we look at that, we put the customer at the center of everything we do.
We make sure that every—and we partner with them to co-create the future of dentistry. We do it across four main pillars. The first one, you've heard a lot from Mitra, is to deliver the best clinical outcome for their patients. Right? It's all about evolving the digital dentistry into comprehensive dentistry. The second one is about growing the practice. If they grow, we grow. We know that dentists like to focus on their patients. They like to deliver care to their patients. They don't necessarily know how to grow their practices. That is also part of our job to help them adopt through the adoption of our tools to grow their practices, grow their business.
The third one is about elevating the patient experience, making it simpler, faster, more comfortable so that they can come back, they will come back and send family members to the same clinic. The last one, in a time where it's getting harder and harder to keep the staff engaged, is delivering an experience for the staff that makes them happy, engaged in what they do every day in the clinic. All of this, at the end of the day, is really to drive oral health and diagnostics. You've heard it already from multiple people today. We're not anymore about doing obscure things. We're here to make sure that we start by diagnosing the patient so that we can give them the best treatment course possible, whether it's about orthorestorative in a comprehensive way or whether it's about delivering restorative dentistry through their labs.
We talked about iTero not being a scanner anymore. Yes, iTero does extremely well in scanning, especially with the introduction of Lumina. The game is not anymore about scanning. There are so many tens of different scanners out there that can take a digital impression, replacing a PVS. That is not where we want to play. That's hygiene, as I call it.
Where we want to play is really throughout the continuum, throughout the patient journey, where the iTero system, the iTero platform, is really playing that key role for our customers to collect the data, which is extremely critical, then aggregate the data into insights so that they can communicate with their patients in a seamless way, agree on which chairside workflow or treatment they need to communicate with their lab or with Invisalign, make sure that they empower their staff in helping them do the critical activities so that they can focus on other things. Lastly, we use the iTero platform for communication, but also for education, education of our customers and education of their patients. We do this with clinical backing, i.e., that we are more and more doing clinical studies and independent publications that show how these innovations perform.
I'll talk about that in a few minutes. We also make sure that we integrate seamlessly with the overall ecosystem. Like I said, it's getting more and more complex. Simplifying and being sure that we integrate with all of these players out there is critical for our customers, simplifies their lives. As an example, we're now connected with more than 20,000 labs in the globe. Lastly, it's about creating efficiencies. Right? We want to—and I'll show you that with Lumina, where we integrate multiple modalities into one wand, into one swipe. Looking at our journey with iTero, we have now a very compelling portfolio that is addressing all the segments from value, performance, all the way to premium. We've sold more than 100,000 scanners to date. We're doing about 5 million plus scanners, rest of scanners on a yearly basis.
As I mentioned, we're connected to more than 20,000 labs. We are catering to as well as the ortho community as we do with the GP segment. This is a snapshot. It's not comprehensive. It's a snapshot that shows the innovations that we've been working on, that we've delivered over the last couple of years. I'll take a few examples that I'm going to dive into. Oral Health Suite. This is what Sree already presented earlier. As we say that iTero is not anymore a scanner, it's a comprehensive platform. It starts by diagnosing any challenges that you have that the patient has in their mouth. We've heard from Dr. Galler how powerful that is. As I mentioned, we obviously look at the data behind it to show how is this helping our customers? Is this moving the needle?
For this specific innovation, we've looked at about 800 customers that are using Align Oral Health or that have it on their system. It looks like for one in a couple of scans and using it once, they were able to increase their top line by $15,000. This includes everything they do in their clinic in a month. Right? Staggering number. Again, this is a proof point when we go and talk to our customers and help them grow their practice, we can showcase some of these innovations and how it will help them grow. Another one is the X-ray Imagery that also Sree talked about earlier, which we've introduced at IDS, and it was a major hit. Now we're bringing this to chairside. We'll have it integrated into our iTero system on our Lumina in the second part of the year.
Invisalign Simulator, the Outcome Simulator Pro. You've heard Dr. Galler talk about it. We've also looked at the data, and it shows that people, customers using it, are getting twice the amount of acceptance from their patients. Now we're going to the next level. We're bringing SmileVideo also on chairside, which has been—SmileVideo has been introduced at IDS just a couple of months ago. Now toward the second part of the year, we will bring it on our iTero platform as well. We keep moving. We keep bringing those innovations that help simplify the life, the work of our customers. The last one I want to talk about before switching to Lumina is iTero Design Suite.
We had a number of customers that came to us and said, "Hey, look, I would love to be able to do some level of design on my system, but I don't want to get the full exocad suite because it's just too complicated for me. I'm just a dentist." We've been brainstorming with them. As I mentioned before, we co-create a lot with our customers. We came up with this idea of taking some of the capabilities of exocad, simplifying it, and putting it on the chairside so that those that want to use it, GPs and ortho that want to use it for simple design, can do so. We introduced this just at the end of 2024, and it's been ramping up in a very good way over the last few months. Now talking about the new kid around the corner here, Lumina Pro.
As you remember, we've introduced Lumina Ortho in February 2024, which was a major hit. It quite helped us grow the iTero business in a significant way. A couple of months ago, in March, we've introduced the Lumina Pro that brings restorative capabilities. This is way more complete than we've ever had. We've added restorative features that are really helping our customers jump on the restorative wagon. Let's roll the video that explains this much better than me.
Think your complex restorative procedures can't be simplified? Think again. Introducing the new iTero Lumina Scanner. It provides the superior accuracy and simplicity you need to achieve exceptional restorative outcomes effortlessly across all procedures, from single unit crowns and bridges to implants, full arch rehabilitation, and removable prosthetics.
Powered by our industry-defining iTero MultiDirect Capture technology, the iTero Lumina Scanner lets you scan accurately twice as fast with a three times larger field of view for higher visualization quality with less effort, handling simple to complex cases quickly with superior clinical accuracy for high confidence in your results with a predictable first-time restoration fit. It's also designed to achieve remarkable workflow efficiency by scanning your cases in a single pass and simplified in-practice 3D printing with iTero Design Suite. Experience an all-in-one device that offers endless possibilities and give your patients a superior experience for exceptional care that helps build trust and confidence. Think you can't simplify your restorative procedures? Think again. The new iTero Lumina Intraoral Scanner redefining simplicity with a wave of a wand.
Think again. All right. This is a slide that I presented a few times already, so it should be familiar with all of you or most of you. It shows the difference between the previous technology, confocal or structured light, and the current technology with Lumina. The idea is flipping the paradigm on how we acquire data. On the left side, you see that it's a complex way to back-project light to the front, which introduces constraints in terms of size and weight of the wand. More components, and the bigger the field of view that you see at the bottom there on the teeth, the more weight and size you're going to introduce.
We flipped that paradigm, and now we're projecting the light right at the tip using six cameras, five projectors that allow us to increase the field of view, increase the depth, while at the same time we're using the size and the weight of the wand. We're throwing away that whole limitation that exists with the old technologies. This is just the beginning. This is just the beginning. We are obviously working in our research department on future improvements that will come on this platform. The benefits that we get: simplicity. The scan is much faster compared to a 5D unit or Ortho scanners. It's half of the time to scan it in a very quick way, including the full palate.
The older modalities, whether it's NIRI, the intraoral scanner, the photos, replacement photogrammetry, no need for camera DSLR, they're all integrated in that one wand and in one scan. You don't need to rescan with multiple modalities. Superior accuracy. We did a lot of tests with other scanners out there. Thanks to this new technology, the accuracy is through the roof, which is allowing us to do work that we were not able to do before in this space, such as, for example, accurate implantology without having the need for a photogrammetry device. Patient experience. If it's shorter, smaller in the mouth, the various restorations come back and they fit properly the first time, it's a great experience for the patient and for the customer, for the doctor. I have a few quotes here.
I'm not going to go through them because we are short on time. We'll share them with you. There's nothing like listening to the feedback of our customers and hearing them telling us about it. Now, the Resto launch has been out there for already two months, and the feedback we're getting is outstanding. All righty. Closing with the slide that one of the slides I opened with, unlocking the full value of iTero. It's not a scanner anymore. It's really moving from a scanner to a platform, from a scanner to an ecosystem that allows our customers to do their job in a more seamless way, easy, simple, and fast. With that, their practice will grow, it will flourish, and their patient will get the best care possible. With that, I will pass it now to Želko, who will talk about comprehensive dentistry. Thank you.
Good morning. Comprehensive dentistry again. I'm going to bring again the two numbers that both Joe and Mitra shared. 75% of us have some kind of malocclusion. The second number that's even more intriguing is that 45% of restorative procedures should start with tooth alignment. When we say should start, it means that they don't. In many cases, the restorative procedures are a consequence of crowding, of malocclusion, misaligned teeth. If they don't start with tooth alignment, you're really not addressing the underlying problem. When you align teeth, you're not just getting better aesthetics. You're getting better function of the bite. You're getting minimal invasive restorations because you have to prep these teeth less. They're going to last longer, and they're going to be aesthetically superior. In terms of health, function, aesthetics, and longevity, half of the restorative procedures are not accomplishing that.
I think the reason is because it's hard to do that. There is no tool that makes it easy to make those comprehensive orthorestorative treatments as opposed to restorative only. When we talk about making tooth alignment a standard of care in dentistry, it's not about making dentists being orthodontic specialists. It's about helping dentists understand the need and the value of the tooth movement through analysis, treatment planning, visualization. That treatment can be done by the dentist herself or referred to an orthodontic specialist based on the complexity. The ability to understand the patient needs and deliver the highest quality of care, that is necessary. I think we can help make that dentistry better by adding tooth alignment to the restorative procedures. A big part of that is the fact that Exocad is part of Align family.
We acquired Exocad five years ago, exactly last month, with a comprehensive suite of dental CAD/CAM solutions. Most powerful and most advanced system in the world. It was a very healthy business five years ago. It's even better today. We have more than 60,000 installations, and our market share, we estimate, is more than 50%. More than half of the labs around the world use Exocad. Now, why is that important? There are more than 2 million doctors, dentists around the world. I would say less than 5% of them think about tooth movement. So 95-plus % of them don't. But all of those dentists, they work with those labs who use Exocad software. How do we leverage labs to help dentists practice comprehensive dentistry? I'll show you some teeth now to explain and visualize. Bear with me.
Here is a colleague of ours who was willing to be a patient for us. He's a normal guy, handsome guy. He wants a better-looking smile. If the dentist sends his case to the lab to design this better smile, and better, hopefully, means more beautiful and healthier, this is what they're going to face. Now a dental technician has to figure out what to do with these teeth. You can see he has tooth wear, he has deep bite, he has crowding, he has problems. It's a very, very tough starting point. This is what happens today. They need to figure out how to fit something restoration that looks better. In terms of function, they have the tool to look at occlusion. David Galler talked about it in a video. You look at where are the contacts. You see the purple thing.
This is where centrals are hitting each other and wearing teeth. Now if the lab technician is trying to create a design and put, let's say, four veneers there, the underlying problem is not going away. Actually, you're likely making it worse. That's the problem. When we talk about the health, when they put these four veneers, some teeth are sticking out because they are not aligned. Everything that's sticking out, to get a good aesthetic outcome, you need to take it away. You need to remove it. There is a lot of tooth mass that this patient would need to have removed to get something aesthetically looking good. It is a very, very tough situation that dentists and dental technicians in labs face every single day.
What we have done, we have added the ability in exocad software with all of the capabilities to have a better starting point. On a click of a button, the lab technician can align these teeth using the power of Invisalign. This is all visualization now. Now you can see on the upper, real teeth. On the lower, the real teeth after alignment. Now you can see the difference. They can compare. Now on the right, you see restorative only situation. You see the situation after orthodontic alignment. No pink colors. The function is good. No more bad contacts. Now look at the healthy part of that. You see the teeth sticking out. exocad has a facial-driven smile design. Look at the situation when you're aligning teeth first. Nothing is sticking out because we moved these teeth. Look at the vertical dimension.
We opened up the bite. Look at the aesthetics just by being able to put teeth in a better position. Let me just focus a little bit on preserving the healthy tooth mass. We have the tools that a technician can use to analyze and then explain to the dentist why these teeth need to be moved. This is the amount of healthy tooth mass that you have to take away. You're taking away enamel. Enamel is the hardest part in our body. It protects the tooth. You take it away, the tooth is weak, exposed. The life gets shorter. Another thing, if you're bonding porcelain veneers on enamel versus dentin, you have 10 times longer lasting restorations. If you bond on dentin after taking enamel off, it's not going to last long. Here is the difference between removing and moving.
When you bring the tooth in the right position, you have a better starting point. When we talk about comprehensive dentistry, the plan should be you start, you align these teeth first, and then you place the restorations. This is why they say that 45% of restorations should start with tooth alignment. You're getting better function, less invasive, healthier, longer lasting, better aesthetics. This is all visualization. Part of the visualization is showing the smile to the doctor and to the patient, showing the smile based on the treatment plan, clinically confident. When you see that, it is hard to say no. Seeing is believing. Seeing yourself like that, it's amazing. If this is not enough, we, of course, give the smile video as well. The emotional response is amazing.
That's why doctors who use smile video have significantly higher rates of patient conversion. This is all simulation. The lab is creating analysis and plan and visualization, creating a report, goes to the doctor. The doctor explains to the patient, sees the benefits, function, health, aesthetics. If the patient agrees, it becomes an Invisalign treatment. It can be treated by the doctor or referred to a specialist. Just Invisalign case. Again, 45% of the cases do not start the way they should start. That's why I think in the future, when a patient like this comes to a dentist asking for a better smile, more beautiful and healthier, what do you think will happen? What will the dentist do? Will the dentist remove or move? What you see on the left is what's being done today.
What you see on the right should be done and will be done in the future. Now, if they do it or when they do it, let's take a look at the numbers. These are just existing restorative procedures. 8 million in the U.S., you take 45% of that, you're getting incremental Invisalign opportunity of $4 billion. You go to EMEA, this number goes up to 6. Between these two markets, not counting Brazil, APAC, you've got $10 billion of incremental revenue. Millions of people are getting better dental treatment, which is the underlying power of comprehensive dentistry. We have introduced this solution within exocad at the IDS show this year. Some of you were there. We're starting the pilot this month in a couple of countries in Europe. I feel really good. Interest is exciting. The labs are very engaged.
I feel very, very good about bringing this to the markets. I do know that Align has the unique ability to deliver this, transforming dentistry to something that's much, much better for patients, for doctors, for all of us. Because we have Invisalign, the best orthodontic system. We have iTero, the best comprehensive scanner, and we have Exocad. We are going to work very hard to bring comprehensive dentistry to reality very, very soon. Thanks a lot. Now I'm going to introduce Frank Quinn.
Thanks, Joe. Good afternoon. I'm Frank Quinn. I'm representing the Americas. I'll walk you through our go-to-market strategy. Still a tremendous market in the Americas. 8 million ortho starts annually, 5 million of those teen, 3 million as adults, and a massive consumer opportunity out there as well. When you take a glance at the Americas, we have a great mix between ortho and GP providers and volumes, as well as a doctor community of 136,000 trained doctors and 55,000 shipped to, with a utilization rate in North America of 28 cases. Obviously, the major markets in the Americas are US, Canada, and Brazil. What we're really looking at on a focused execution on these strategic growth drivers for the Americas is, first and foremost, orthodontic utilization, GP dentist adoption, joining the franchise and getting started. Next is DSO and clinic growth.
Last but not least is consumer demand and conversion. The main foundation amongst each of these doctor channels is clinical education. You'll hear me mention this many times throughout the talk here. Our go-to-market strategy is really designed to accelerate adoption, improve utilization, and enhance the overall customer experience. We're focused on three pillars to actually execute upon that. It's focused execution on growth drivers. It's commercial excellence and sales force optimization. I think Joe had mentioned this before about kicking down doors. Really making sure right customers at the right time, at the right cadence. Last is the demand generation and brand differentiation as well. I'll share a video here shortly as an example of how we're doing that. When you look at the accelerating ortho utilization, there's three key things that we're highly focused on.
It's really repositioning the ortho brand as a partner for growth through community and partnerships. This is really anchored on the clinical education piece. When you think of in the Americas, it is a very community-based specialty. Love learning peer-to-peer. Setting up as many of our education events as possible to encourage not only the education and the usage of our platform, but also sharing best practices peer-to-peer. Between all the three channels I had mentioned, we'll do over 500 live events, live education events this year in the Americas. Reshaping the ortho business model and growing patient innovation leader. I mean, you saw the portfolio multiple times from palatal expander to first for mixed dentition, and then our mandibular advancement tools. Obviously moving through the journey as well.
You have Invisalign for kids and teens, but you also have DSP for touch-up cases or finishing off braces cases, retention, and then our comprehensive portfolio for the more complex case types. Accelerate the ortho journey with enhanced clinical confidence goes hand in hand not only with the education, but all the tools and enablers that you saw earlier today. From the GP dentist adoption perspective, attract and enable new providers. New marketing omnichannel campaigns to the broad community of GPs out there that are not only not leveraging Invisalign nor iTero are entering into the franchise with great education events and leveraging our resources to get started. Accelerate the practice growth with pathways, products, and partnerships. We're deeply immersed with many of the partners around the Americas, AACA, , Spear as an example.
Being present in everyday dentistry as the opportunity to move teeth instead of removing them. Then build GP relevance through iTero scanning integration in those key institutions I already mentioned. The next is the DSOs and OSOs, stands for Dental Service Organization and Ortho Service Organizations. Strengthen DSO relevance with brand preference and value prop, driving deeper engagement with new providers and programs and co-marketing. The unique thing about the DSO and the OSO channel is that they have a unique opportunity to scale and scale quickly. They are set up very similar to us. They have their clinical function, marketing, finance, all the way across the board. We get an opportunity to marry our resources and expertise with them. They can scale that, and it creates a flywheel experience.
It's also a great landing place as they acquire businesses or students that are graduating, whether dental school or residency, have a nice soft landing place as they enter into these organizations. The last piece is accelerate digital adoption and ClinCheck innovation with an iTero scanning. The reason why this is critical as well, each one of these organizations has a clinical leader. It could be a Chief Clinical Officer. Typically, they're very good Invisalign users, and they set up those templates with IPE and then broadly put that out in the organization for their doctor community so they have standardization on treatment and outcomes. Just a brief look at some of the top players in the U.S. You can see Heartland there with almost 1,600, MB2, Smile Doctors, Schulman Group, some really a great footprint in the U.S. Same thing holds true in Canada.
There is tremendous opportunity in this channel as well. I mentioned clinical education. It's not just in one part of the journey. It's an always-on type thing. Capturing the dental student or residents early, 2,000 dental students educated annually. We use AIF as an education tool for them as well. The last piece I'll share is this two-day care course, which was started a couple of years ago. I had the opportunity to attend one of these in Scottsdale a few months ago. I think there was about 130 residents there, and it's fantastic. They're not only learning clinical, they're learning workflow, but they're really learning from their soon-to-be peers on the mistakes maybe they made as they entered into practice and why digital is really the answer as you enter into practice, whether it's as an associate or hanging your shingle and opening it yourself.
Material education grant for students, 100% in the orthodontic programs. These clinical pathways. Everything we're doing is anchored on clinical education and pathways. Equally important is being in the field and present on practice support and integration. On Latam, slightly unique focus here. It's a different environment. We're focused on affordability, leveraging the portfolio and Invisalign Pay, multidisciplinary, very similar to some of the countries in Europe. General dentist, ortho, could be an oral surgeon, perio. This is why the iTero Lumina plays such a huge play, is so important in this space from a multidisciplinary perspective, and ensuring that our go-to-market motion and approach really has multiple resources for those multidisciplinary accounts. Once again, clinical education. I told you I'd mention it a few times.
From a demand perspective, it's really about igniting demand and shaping a culture of confidence with real people and real stories. Very region-specific, U.S., Canada, Brazil, localized, ensuring that we're highlighting these real people every day. Adults over 45 is a growing population of those seeking to better themselves and improve their health. Ensuring that we're highlighting that. Doctor as a hero, critical. We can't do this without our doctor community. Some of the work that they do is exceptional. As a matter of fact, we were just at AAO a couple of weeks ago. We had 18 doctors come in to record and share their experiences. The thing that was amazing to me is many of them got emotional about what happened in their lives, in their practices, and the way they treat patients as they went on this digital transformation with Align.
Getting that out broadly with Doctor as the Hero, obviously parents with kids, and Spanish in the U.S. The Spanish and Latino and Latina community has almost $3 billion in buying power in the U.S. alone. I had mentioned protecting the Invisalign brand. This is Kat Stickler. On TikTok alone, she's got 10.5 million followers. We had actually reached out to her to say, "Hey, you've got a great followership, right demographic. We'd love to get you started with Invisalign." I'll play the video, and you can see how it unfolded.
Last year, Invisalign reached out to me. They were like, "Cat, we'd love to work with you." I said, "Respectfully, absolutely not. Your product did not work." They were like, "Let's hop on a call. I doubt it was our product." I was like, "Okay, confident." We hopped on the call. I poured my heart out that I was very disappointed. They were like, "You did not use real Invisalign aligners." I said, "What do you mean?" We referred to them as that. They go, "No, Cat, this," they sent me the real one. This is how the case is supposed to look. Little star there, circle. Not like this. Not like this. Also, they are clear, and they go around your mouth. They should have the Invisalign star on the back tooth. Mine did not have that. They were just clear.
A great example of us ensuring that when a consumer enters a practice, they know how to identify an Invisalign case. Our omnichannel media approach targeting three core audiences: adults, parents with kids, and teens. Obviously, TV and YouTube play a huge part of this. The secondary area is influencers and social media with adult, mom, and teen. The practice marketing is critical as well. When a consumer identifies Invisalign and they see what the brand represents, they want to have that same look and feel and experience as they enter the practice. Ensuring not only in the practice, but the websites and the media that they put out at a practice level. The last piece is partnerships. Overtime is mentioned here. This is like ESPN for kids and high schoolers.
Millions and millions of hits and views every single day, highlighting kids and teens that are leveraging Invisalign on that. You have the NFL and Disney. You can see a wide spectrum of influencers and women in sports as well. You see Patrick Mahomes there. We've seen him chewing on what we thought was his mouth guard for years. It was actually Invisalign. He's joined us, and you'll see new content coming out from Mahomes as well. The last piece on the bottom right is really a critical component of this. This is all great, driving demand, but you have to bring the doctor into the mix. In the NFL partnership, we've treated over 500 NFL players already through our Invisalign providers. That's Dr. Zach Casagrande from Virginia treating Jayden Daniels, who was the NFL Rookie of the Year.
Really highlighting that doctor as the hero, the outstanding experience, and building confidence for kids and teens. From a commercial excellence and sales force optimization perspective, we're really looking to capture the demand, strengthening our commercial capabilities, and really pointing the sales force and the right reach and frequency for the customers of where they are in the journey. Requires significant focus and simplification, not only internally, but around the customer. Everything orients around the customer. Execute and deliver outstanding results. Two key revenue drivers in this business, Invisalign, including Vivera and retention, and iTero, leveraging all the great tools and enablers that you saw throughout the day to ensure that you have higher utilization and adoption of both of those and move into a digital dentistry and orthodontics phase. Key takeaways, obviously an enormous opportunity in the Americas.
Winning the hearts and minds of the orthos really begins with respect. They're entrepreneurs. They're specialists. They do incredible work. Really, this is a knee-to-knee, eye-to-eye business. That's why having our direct sales force and distribution is so critical. We actually don't kick down doors. We walk in and have those business planning meetings and identifying the objectives for the doctor and where they want to go. Relevance with GPs to drive adoption, connecting consumers into the practices and driving demand, growing the OSO footprint, and lastly, accelerating growth. Thank you. Going to welcome up David Carr.
Thank you, Frank. Good afternoon, everybody. I thought I'd start with a brief introduction. I'm one of the newer members of the Align leadership team. I'm not a stranger to the APAC region, despite the accent. Started out my career almost 30 years ago as an automotive design engineer in Japan. In the 20-plus years that I've been in the med tech world with GE Healthcare, more recently Medtronic, I've either been located in the APAC region or had responsibility for the APAC region. Look, delighted to be part of Align, the leadership team, and excited about the opportunity and the prospects for this company. Very quickly, I'd like to kind of introduce what I believe is the opportunity for Align in the APAC region. Similar to the US, we have a significant addressable market.
In my years of covering the APAC market, we've always talked about growth being driven by the kind of regular demographic and economic development of the region. In this business, it's more than that. There are enhancing beauty standards and expectations among both men and women. There's also greater awareness of oral health. When you think about that, in addition to the fact that APAC is probably home to the greatest prevalence of complex malocclusions, Class 2, especially Class 3 in China, Korea, Japan, there's a significant opportunity for us. When we think about all those technologies that Srini and Sri have introduced today that help us address growing patients with alternatives to wires and brackets, I think there's a tremendous opportunity for us in APAC to continue growing at double digit for the foreseeable future. Tremendous opportunity to convert the wires and brackets market.
On this page, you'll see our major markets listed. For a long time, China, Japan, and Australia, in particular, have contributed to more than 70% of our revenues. What we are seeing through very deliberate investments in what we believe can be fast-growing markets, we're going to see a reordering of our major markets even this year. When I look at India, I fully expect that by the end of the year, India will be our third highest volume market in Asia-Pacific, and Korea quickly catching up too. We do have significant progress being made in those markets where we're making very intentional investments. Our strategy since the last investor day remains unchanged. Focus on international expansion, utilization, adoption, and of course, driving demand for our customers through consumer marketing.
Over the next four pages, I just want to dive a little deeper into give you illustrate how we're making progress in executing the strategy by market, by product, and how we drive demand in the region. I fully expected all of you to want to know how we're doing in China. Do we have a competitive strategy in China? The answer is yes. Years back, we made the decision to be in China for China. We are operating as a local entity in China today. We're doing a great job. We have this formula of, like we do in every market, looking to expand our submitter base. We're doing this through stronger partnerships with DSOs, expanding beyond the tier one cities where we typically grew our business years back. I'll talk in a few moments about the growing patient portfolio.
Today in China, we still have clear aligner brand leadership. We are still perceived as the best aligner system on the market. Doctors and patients are still willing to pay a premium for Invisalign. Just to give you one more proof point on this, we ran a recent Master Day forum in Shanghai. We had 69,000 people attend the event. I've never seen anything like this in my career in healthcare. 1,500 in the room, 67,000 people dialed in remotely. That just demonstrates to you the value that China still places on our contribution to innovation and how we educate customers in that market. It's a significant proof point for us. If we feel good about China, we remain the number one revenue share in China. I'm pretty confident that in quarter one, we took share from our major local players. I feel pretty good.
Obviously, with VBP on the horizon for us, we feel pretty good about having that local presence to ensure that we maintain a leadership position in China. You've heard a lot about the growing patients portfolio from a number of the team today. If you just think back to what I said a moment ago about how China, Korea, and Japan are home to the world's highest rates of complex malocclusions, there is a very significant opportunity in China for us to address. We've worked very closely. Across APAC, I should say, this isn't just about China. If I take China specifically, it's probably the one market even globally where the associations are working very hard to raise awareness of the benefits of early intervention with kids. We're working very closely with them to build educational offerings, to drive clinical confidence, generate clinical evidence.
There's a tremendous opportunity here in how we partner with the local associations. Thirdly, we obviously have the portfolio. We're going to be launching IPE later. We just got regulatory approval for IPE last week in China, and across the region, India and Korea in the last few weeks too. There's a tremendous advantage we have here with our product portfolio. Lastly, the one really important thing here, and it's a cultural thing. Parents in Asia are willing to pay for anything for their kids. They will always prioritize their kids. When I think about just the resilience of this segment for any economic headwinds that we might face, I feel very confident that the growing patients opportunity in Asia-Pacific remains our greatest growth opportunity, fastest growing market. We see it already.
The percentage of our revenues across Asia-Pacific being driven by the growing patients portfolio is growing year over year at the fastest rate. My last two slides are very much about demand generation. Demand within our customer base and how we expand our customer base, and obviously the consumer demand side. We call it the programmatic in Asia-Pacific, a programmatic approach to growing our business. This is the crux of our business. This is hard work. It's all about growing submitters and growing utilization. This is where you need discipline in the organization. Last year, we ran over 1,500 educational events. 20,000 participants attended our events. Just in quarter one alone in 2025, we've continued to kind of up the ante on this. We had over 9,000 participants in our new doctor onboarding and our growth programs.
We know that those participants typically grow at two to three times the rate of the non-program participants simply because they're getting greater access to education, more contact, building their confidence in our products and new offerings. That is how we take them on that journey from adoption, building confidence. We introduce more of the digital workflow, and we help them build successful practices. This is what also drives a stickiness among our customer base. We also have treatment planning services, which support people as they continue building their confidence in adopting our technologies. Finally, we think longer term and how we're investing with universities. We have partnerships with over 124 universities across the region. Finally, we talk about community a lot. We've built a great business for ourselves and for our customers in the region.
A lot of our customers give us a lot of credit for their success. In Bangkok, in a little over four weeks' time, we are going to have over 2,000 customers join us for what should be the biggest dental event of the year in the region, probably one of the biggest events for Align in its history. That event is all about education. There is a lot of clinical education, but there are also very comprehensive workshops on practice efficiency and practice development. I feel really good about how we are driving demand within the customer base. Finally, it is also about driving demand and helping to generate demand among patients. This is something that our customer base depend on us for. This is a big part of how and why they like working with Align in the region.
The investments we've made in consumer marketing drive demand, which leads to direct visits and customers showing up asking for Invisalign. What we're doing now is making sure that the content we use is fully localized by market. We're also complementing it and making sure that it represents a superiority and differentiation we believe we offer in our product portfolio. I'd just like to show you a sample of how we've localized our consumer marketing across the region. If you can play the video, please.
Get ready for the revolution. It's coming to you now. Invisalign is as precise as my aim. When it comes to results, the smile you want is the smile you get.
For my smile, I trust Invisalign. I can make riddles with no problem. It's coming to you now.
With Invisalign, it's like flipping a switch. Quick, clear, zero drama.
The SmartTrack material, millions of patients treated worldwide, and the predictable outcomes. That is why for my smile, it had to be Invisalign. It's coming to you now.
Invisalign, wedding smile. अब looks जो भी हो, angles जो भी हो, मेरी smile, मेरी entry, totally unforgettable.
All right. We all love the last one, I think. Just to wrap up, I think it's clear. We have a very sustainable pathway to double digit growth in the Asia-Pacific region. We've got a great portfolio. We have a very large community of loyal customers that we've worked together in developing this business and this segment within dentistry. Above all, we have a highly disciplined and tenured team in the region. Thank you all very much. I will hand over now to Simon Beard.
Thanks. Good job. Okay. Good afternoon. Hopefully, I'm not going to disappoint you. I'm not going to show you any fancy videos. What I do want to do, though, is kind of excite you around the opportunity that exists within the EMEA region. Like my colleagues, the total potential market really dwarfs the actual market size that we see today. That is what really kind of inspires us and what really drives us every single day when you look at the potential that exists across each of our regions. I wanted to start by showing you kind of a quick breakdown of the EMEA region. You can see that from a volume clear alignment perspective, we're dominated by the ortho channel. Countries like Iberia, Italy, Germany, Turkey, France, we drive very strong ortho volumes.
The GP side really is dominated by the U.K. and Ireland, which makes up the majority of our business there. If you look at doctorship too, we've seen quite a big increase over the last few years as far as the number of customers that we serve in the region. That is a combination of our core markets, but also our expansion markets I'll talk about later. If you take our top three markets, which is Iberia, U.K.I., and Italy, they make up over 50% of our volume and revenue. Really strong contributors to the overall region. Like Frank and David, we focus on these key strategic growth drivers, which are pretty consistent. It includes ortho, GP, and DSO growth. One slight difference within EMEA is this real focus around geographic expansion. Like I say, I'll talk about that a little bit later.
Let's start with ortho. With ortho, a real focus around accelerating growing patients, which you'll have seen that the team are doing a really great job. Peer to peer is a program that was introduced 18 months ago. I'm going to show a separate slide on that. That is really a foundational strategy for us at the moment and really driving our ortho utilization. This year in EMEA, we actually have finally been able to get our hands on products like the palatal expander. Today, actually, we are launching the Invisalign mandibular advancement with a occlusal block across the EMEA region. Those two products, particularly IPE, which has been really well received, Europe is a very strong phase one interceptive market.
Finally, building on North America, we recently launched the doctor subscription program, which has really been very well received by orthodontists across Europe. We continue to add submitters there. On the GP side, one of the primary focuses has really been looking at how we increase our submitter base, not only in the U.K., but across Europe. Really, how we're kind of approaching that differently, I'll talk to you in a moment. One of the key things is everything that Želko and Karim have said and also Sree is how do we bring this incredible technology platform together that really keeps it very, very relevant to our general dentist customers. Things like obviously the iTero Lumina, the new restorative capabilities, is really going to give us a massive opportunity there.
Other things like the Align Oral Health Suite and X-ray Insight, which is available in Europe, really talk to what a general dentist does on a day-to-day basis, which is diagnostics and then treatment planning. The reason this is so important and what reason we're so excited about it is we truly believe that the general dentist is the gateway to the adult patient, whether that's from an orthodontic perspective or, as Želko showed you, from an ortho kind of restorative or comprehensive dentistry angle. Let's just circle back. On your left-hand side, I wanted to take you through the ortho peer to peer. This program was developed in Italy and has now been introduced across every market in EMEA.
This is a 12-month program where we take our very best customers and we pair them with 10-15 doctors who have got kind of low experience, low confidence. They educate these doctors colleague to colleague on both the clinical side, but also the digital workflow side. They give them ClinCheck mentorship, so they are showing them how to set up clinical cases. We use this network of mentors to primarily drive our new innovation. They get access to our new innovation slightly earlier so that they can build confidence, and then they teach their colleagues. On a rolling basis, we have got about over 3,000 doctors who are involved in this program. The really cool thing has been to see the strong growth that we are seeing, particularly in kids and teens, which is a key part of our strategy.
On the right-hand side is the Invisalign digital mentoring program, which is focused on GPs. Now, this is a newer program. We totally reimagined our training program for GPs the middle of last year, particularly when we're certifying new GPs. We flipped the model on the head based on everything we've learned over the years. We first train our doctors on iTero Lumina and the Align Oral Health Suite so that they then spend a month really getting that ingrained in their day-to-day workflows so that when they're doing a consult with a new patient, they're actually, rather than using a mirror and a probe, they're scanning and then talking to the patient about what's actually happening in their oral health cavity.
After that month, we bring them in, we train them on Invisalign Go, and then give them strong mentorship and support with treatment planning and ongoing education. The cool thing is, is the early pilot results. We saw both a two and a half X increase in not only Invisalign cases, but just as significantly for a general dental practice for their restorative cases. They can truly see that the iTero Lumina and all the diagnostic tools that my colleagues have spoken about truly do make a difference to patient conversion and connection. We launched in the U.K., France, and DACH and Nordics, and we will be rolling this across the rest of the region. DSO is becoming an increasingly important part of our business. We are learning a lot from colleagues in North America on how we build and scale our business to support those doctors.
We have made a lot of progress in really making sure that the propositions that we have, because sometimes you're looking at multi-geographic locations, mixed specialty within Europe, and how can we really build a tailored, flexible solution to help them grow and scale. We believe we're in a great position to do that, particularly with our portfolio, but also the scale that we have in that region. Onto expansion markets. Expansion markets have been really incredibly important to this region. We have consistently seen fast and strong growth. We have learned a lot over the years about what's the playbook when we enter a new market, when we go direct. What can we do to ensure that we get that kind of fast growth? A good example of that has been Turkey, which was an expansion market seven years ago.
Last year, we brought it into our core group because we'd had great success in really scaling and growing and accelerating that business. We currently have 34 markets that we're operating in, a mixture of direct and distribution. Within those 34 markets, there are five that are absolutely critical and we're really focused on, which are Saudi Arabia, Poland, Greece, Israel, and South Africa, all of which have enormous opportunities to grow and are performing well at the moment. I wasn't going to just leave consumer out because consumer still is an important part of our overall commercial strategy. We are limited a lot by the local regulations and legal rules that exist within Europe about not being able to actually advertise to consumers.
There are some markets like the U.K. and Germany and France where we can go direct as far as our advertising is concerned. The team have done a great job across both kind of search, social media, and also through engagement on our platforms. We have seen record levels of consumers going on to Doc Locator looking for a doctor to treat them with Invisalign. They have also done a great job in maintaining the strong preference and sentiment for Invisalign over all other products. Just to close, EMEA is a double digit growth region, high growth in growing patients with iTero Lumina and also with our expansion markets. We also see a really strong adoption and connection with our new innovation from doctors. We have really seen the ability of using communities and peer-to-peer type relationships to really drive that growth.
Like the other regions, we're really focused on keeping our business as simple as possible for our customers and focusing around execution. The message I want to leave with all of you is there is an abundance of opportunity, whether it's looking at the different customer channels, segments, or the geographies. Thanks for listening. I'm now going to hand over to the man you've all been waiting for. That's John Morici, our CFO. Thank you.
Thank you, Simon. Good afternoon. I do want to talk about bringing this all together because you saw a lot of great content, great ideas, things that we're doing to affect the business, grow our business, become the standard of care. I want to go through a few slides before I tell you what it means for our model and our business going forward from a financial standpoint. I want to take us back a couple of years here. If you look at what Joe showed, and he talked about the growth that we had at a business just going back to 2018 to 2024, growing our business $4 billion in revenue, double digit CAGR on revenue, same way in volume. And you've seen that.
To get to that, and I'll get into this in one second, takes a lot of new products, a lot of different ways that you need to be able to go after that market and be able to get that type of growth. The same way when you think about teens, these growing adults that we have, to be able to have products that a lot of my colleagues talked about, products to be able to help drive growth, become more relevant in this sector, to get down into the not just teens, but growing adults, being able to get into the kids, into new markets that we haven't been before. It takes new products to be able to get to that, to be able to see this type of growth. We're pleased with our growth.
When you look at what it means for our financials, I want to take you through a couple of views of this. If you have not guessed before, or a lot of you have asked me in the past, I get a lot of ASP questions about what is happening with our ASPs, where they are going. When you look at our product portfolio of what we started with, just going back to 2018, we were essentially two products. We had a comprehensive unlimited, five years unlimited aligners, basically trying to get orthodontists in particular to be able to use our products to be able to treat the cases that they have. The rest was non-comm, five sets of aligners, seven sets of aligners, 10 stages, and so on.
As we've evolved our portfolio and we've been able to say, "Look, what are the new products that we have?" You look at Comp 3 and 3. Some of you talk about that. We introduced that two and a half years ago. It's our number one selling product that we have. We used to have comprehensive unlimited at 76%, and now it's not even our top selling product. You look at products like First, my colleagues talked about that, on being able to treat cases that are help doctors treat cases for five-year-olds, six-year-olds, seven-year-olds. IPE falls into that category. We talk a lot about some of the touch-up cases.
These are cases where maybe there is a relapse that happens or someone just says, "Look, I don't need as much treatment," or if they're following what Želko talked about, "Hey, move the teeth first before you do some restorative." That is a touch-up case. Guess what? On some of those cases that we've now introduced and products that we have, some of them have lower list prices. It is just the reality of the business. There is less cost to serve. It costs us maybe to ship the aligners, and there is no refinement. That is really good for us from a margin standpoint. It is not as much gross margin dollars, but it is a significant amount of margin rate. Same way with the mid-high, some of the moderate cases that we now treat with some of the products that we have, we did not even have moderate back in 2018.
You introduce these products, you get higher utilization, you get doctors to come into the ecosystem. When you look at the doctor growth that we've had from 2018 to 2024, it's tremendous. Why? Because new doctors come in and they start using our products. They might not use the most comprehensive unlimited product. It's okay. They haven't started with that. They're not maybe attuned to that, but they can use products that we have, and it gets them into the ecosystem. There's a product mix that I talk a lot about. That's product mix here. I'm going to show you in a couple of slides what it means altogether. You also have emerging markets. My colleagues just talked about how we're growing in some of these markets, emerging APAC, Southeast Asia, where we're growing in LATAM.
You grow in Turkey and Middle East and other places. Sometimes the products that serve that market, just given the market dynamics that are there, they're less ASP. They're just a lower ASP product. It might even be the same product that's sold in other markets, but it has a lower ASP, lower list price. What you find there is you could get massive market expansion. You can grow in those areas. You can get doctors to start maybe using some of those lower list price products, and they grow, they start to learn their practice and how it fits into their practice. Guess what? They start working their way up to do more comprehensive cases, and it really becomes a part of their practice. Turkey is a great example of that.
Lower list price, but the new doctors that we have and the utilization that they have is phenomenal. We do not see that a lot. When we have that opportunity, we are going to continue to grow. It is what Joe talked about before, about having a direct sales force to be able to sell into those markets. It is very critical. You say, "Okay, what does that mean for an overall ASP standpoint?" For us kind of finance geeks, I can at least show you this to where things are at. If you looked at our total total ASP, blue line there, going back to 2018, we started this journey through here. That total ASP includes any foreign exchange. It is just the reported numbers that we have going back to that time.
If we adjust for foreign exchange, the green line that you see there, you could see prior to COVID, close to 1,290-ish or so, post-COVID, around that same number. You have a dip during COVID. It's a difference between primaries and secondaries and so on. You can see the volume growth that you had there. There is a significant piece of FX that hits this. What does that say? Despite the growth that we talk about with all the new products and driving utilization, new doctors and so on, and the mixed effects that you have, the underlying ASPs in each of these markets and each of these products are stable. In some cases, they go up. We do list price increases. We manage our discounts and so on.
I think the headline that comes through, and I get it, ASP is the headline that you have in terms of what the market is, what we're having in terms of our growth and so on. It is the underlying parts to this that allows us to grow our volume, grow our utilization, sell to more doctors, and ultimately drive profitability. I'll take you through what that means. When you look at now on a future basis of what that global opportunity is, you talk about, and my colleagues talked about 600 million potential patients, 22 million orthodontic case starts, a couple million doctors, huge opportunity. When we think about playing offense to focus execution, I've been here nine years now, almost nine years now.
I've never seen the opportunity that we have in each of our ways that we can try to help grow this business, whether it's brand that we've talked about, some of the videos that you see in terms of people know what Invisalign is. They know about us. We've been able to advertise for 28 years. It means a lot. It means a lot, especially in this environment when there's the me toos out there. We have to make sure that we let our brand talk about what we are as a company instead of them talking about something that acts similar to us.
All the doctors that we have, all the partnerships that we have, we talked about some of the KOLs and some of the training and things that we're doing with growing patients and so on, but giving those doctors the tools that they need to be able to treat now a wide variety of cases. They could treat back in 2018, we could maybe treat 60% of the cases. Now in doctors' hands, they could treat 100% of the cases, giving them the tools that they need. A large part of what we talked about today is how do we expand that? What are we doing from a go-to-market standpoint that's going to give new innovations, new products, new technology, being able to get at opportunities that are right in front of us? Želko did a great job.
I always cringe when I see this teeth shaved down and what it is. That's the reality of what's happening. That's going on right now today. If we can get that message out to people, to doctors, maybe even patients, any one of you, if you go to and you see something like that, you might want to ask a few questions when you talk to your doctor or your dentist about what they're going to do. Are they going to shave that down or not? Make this the standard of care. Educate patients so that they can then talk to their doctor about what they're doing or what they're not doing. So much of that's education. Being able to scale.
Next couple of pages, I want to talk a little bit about the scale, what it means as a growth driver to our business, to be able to drive and improve our cost and efficiency so that we can fund a lot of the new growth initiatives that Srini and Emory and others are talking about to be able to grow this business. We need to be able to fund that to be able to get into some of these new products. Continue on the innovation. Sri and Mitra and others talked about what are we doing from a treatment planning standpoint? David Galler, great presentation about taking all those tools together and turning something into an innovative digital solution to be able to solve the problems that they have. When I take that and I say, "What does it mean for us?
What does it mean for us going forward? Last week, we talked about what it meant for 2025 at earnings. I'll officially reiterate 3.5%-5.5% for revenue and about 5% volume, clear aligner volume. We talk mid-single digits, but that's what it means. There are a lot of things that are going in. A lot of the tools and products that you just saw from my colleagues, that's in what we're trying to do. Because what you see here, and just to be clear on the market, I'm not assuming a market getting better. You wake up one day and there's a tweet about this, or there's a tariff about this, and there's a consumer sentiment about this. I can't predict that. What we are going to predict is due to things that we can do.
We can grow our business in a meaningful way to build off of where we need to go in 2025 based on some of these initiatives that we have. We're going to add to that when we look at 2026 to 2028. Again, not assuming the market gets better. The market is this. It's maybe higher inflation, maybe concerns about trade, maybe concerns about slowing economies and so on. Consumer sentiment where it's at, it's what it is. We can be in the 5%-15%, both from revenue and a clear aligner volume.
Doing the things that we talked about here with direct printing and Lumina platform, scaling out all this and scaling it in a way, and I'll show you some of the financials coming up, but doing this in a way that's respectful for driving the growth and getting the opportunity, but doing it in a way that drives the profitability in the right way as well. Because we need that to be able to invest back into the business. In 2029, it put it out there in terms of continuing new opportunities, taking those platforms to the next level, AI and other technology that we'll bring in, Lumina with Karim talking about things, direct printing that we talked about, AI improved products to be able to get to, but having new opportunities, and we're going to continue to fund those.
God willing, maybe the market gets better, but without the market, we're still going to drive to these growth numbers. I want to double-click a bit on operations and kind of how important it is. Because as was discussed earlier, we're going to be doing the traditional manufacturing for years to come. It's just a reality of what we have. When I look at material, labor, overhead, logistics, that's about $1 billion of cost, roughly split across these four categories, split pretty equally. We have a lot of things that we can do to be able to drive productivity, continue to take material costs out, a lot of things that we're doing to automate and improve from a labor and overhead standpoint, just to be smart about our operations.
When we're scaling and making over a million aligners a day to two million aligners a day to ultimately three million aligners a day, every penny matters. Every penny per aligner matters. It makes a difference whether you're growing your gross margin and op margin or not. We have got to continue to take costs out. That includes logistics. In the next page, I'll talk about our logistics and kind of our footprint that we have, but logistics really become an important piece. When I look at that piece, it's as meaningful as labor or materials from a cost standpoint. You're airshipping things all to different locations. There are so many packages that are going out that that cost of logistics really matters. That influences us in terms of where our manufacturing is and how we manufacture.
Because when you look at our overall footprint, back in the day, we had Costa Rica treatment planning and manufacturing in Mexico. That's how we started out. We scaled that. We did an excellent job scaling that. Now we took that to the region, put it in China, treatment planning and so on. David talked about in China, for China and so on. Thank God we did. That limits the amount of tariff, our other impact that we have is minimal in China. We made that decision years ago to be at that. In a similar way in Poland as well, to be able to have our manufacturing there and really diversify our supply chain. As we continue to scale and you take some of these new technologies, we're going to have opportunities to be even closer to our customers. That's a good thing.
Because if we do it the right way from a material, labor, and overhead standpoint and keep those costs down and as low as possible, it might not be as cheap as it is to make something in Mexico. If I can offset that higher cost that's made somewhere else, even the U.S., if that's where we go, I'm going to save in freight. Net-net it should be a benefit. At the very least, it shouldn't be worse. Especially with our new technology, it's nice having it in some of these locations as well. Our manufacturing and our operational footprint gives us a lot of opportunity to help do things in an efficient way and help scale this the right way. When I think about what it means from a margin standpoint, and we look at our margins and our gross margin means a lot.
What I was just talking to you about ASPs, it doesn't matter at all if your ASPs, whatever they're at, to low stage and moderate products and whatever else, if they're not driving to gross margin, then you're just talking about it. We've got to be able to show that we can do things. Doing things like we're talking about for 2025 to be able to expand and grow and do the things that we want to do despite still having some headwinds. I'll put tariffs out there. It's what it is. Right now, it's $1 million a month that we see this year.
Could be more, but we're going to operate in the right way to be able to drive as much efficiency as possible, be in the right countries that give us the best opportunity to operate better for our doctors, closer to our customers and so on. Oh, by the way, it might even help us mitigate some of the tariff concerns that we have. We need to be able to drive that gross margin to be able to make sure that as we have new products, some of those new products under direct fab, until we fully scale this out, when you're making a million aligners a day under current manufacturing, there's a lot of efficiencies that you can drive. When you're talking about some of the products that Emery and Srini was talking about, you're not making that many a day. Therefore, they're more expensive.
We need scale to be able to keep our costs out. As we go from not making a many a day to a lot a day, we need to be able to drive productivity in other places. We are committed to doing that. Despite the scale-up, despite the things that we need, we are going to be at those margins here. In the future, be above 73% because a good med tech company should be at that. If we are introducing the right products and growing the market the right way and utilizing our facilities and so on, we can be back to that or above. Same way from an op margin standpoint. We talked about this year, the 22.5%. That is a 70 basis point improvement from last year. Good. Great. We should be doing that. We should be doing better than that.
When we think about the productivity that we can drive and what it means from a gross margin, that should fall through. We should also be getting benefit on an op standpoint. We should look at things and say, "Look, we've spent a lot of R&D and there's great new products and improvements that we have." Eventually, that has to turn from an R to a D to eventually, you don't need to necessarily spend on it. You bear or lower some of your costs related to that. Great. Now we have new products hitting the market. That's revenue. MAOB, IPE, when Lumina came out and so on. That's millions of dollars of investment that we've had to make to get to really great products that make a difference for our customers. I don't have to spend that as much anymore.
Now I can enjoy the revenue benefit. You'll see that OpEx leverage coming through in addition to the gross margin benefits that we have. This was put out today. This summarizes everything that I'm talking about here. For 2025, a confirmation of what I just walked through here. The numbers that I show here, this shows GAAP and non-GAAP to better reconcile between the two for 2026-2028 in this environment. For 2029, what we think we can get it back to. That just summarizes our outlook and what we think our model represents.
I wanted to go back a little bit too to say, and I know Rule of 40 to me is an important metric because everything I was just talking about growth, everything I was just talking about profitability, it really, we don't necessarily manage to Rule of 40, but I think it's a good framework to have. It's just taking revenue growth plus op margin. How do you compare? Really, it's not so much comparing to others. You could. Rule of 40 is, okay, what companies are above 40, what companies are below 40. I almost look at it comparing back to ourselves. Where were we before? You have kind of that COVID macro piece of it there. In 2022, you have no revenue growth, negative revenue growth, and your op margins hit. We start working our way back 2023, 2024.
Even in this framework here, when we talk about the margin that we're going to generate in 2025 and the revenue growth that we have, 26%-28%. As we start to scale, as we start to do the things that we were just talking about doing on how we're going to go to market with the new products and the future that we have, we can be able to, in 2026-2028, be in the 28%-40%. Depending on what the economy does. In the end, we should be able to drive to this range regardless of what the economy does. If the economy gets better, great. We know we're a discretionary product in the end. Even for teens, sadly, they get to a certain point where they need treatment. Do they go into treatment or not? Do they go through the doctor or not?
That is what happens. When we have a decent economy, plus all the things we are doing, we can get back into that Rule of 40 framework. A lot of what we talked about is our strategic advantages and what we are. We have seen us talk about this a lot. Everything that came up today, whether it is product-related or digital platform or some of the workforce that we have, the manufacturing excellence, the expansion, and so on. Companies try to pick off different pieces of it. No one has all of this. No one has all of this. The reason why I know no one has all of this is because no one has the profitability, the business growth coupled with profitability that we have. We have these strategic advantages.
When you think about what we do and what we think about as we're investing for the company, we're investing for growth. We're a growth company. We are going to continue to focus on customers, expand operationally where it makes sense, come up with these new products to be able to grow submitters and grow our utilization. Basic equation. That drives volume. That drives revenue. That ultimately drives profitability. We have to continue to do that with those investments to drive that growth, but do it in a profitable way. Because what does that give us? That gives us free cash flow to do all that again and continue to invest that. We're committed to, once we fund the business, once we fund some of the CapEx that we need, we've done some strategic acquisitions, using our own cash to be able to get to that.
The rest of the cash goes back to shareholders. That is our commitment to use this from a cash flow standpoint. Because we have generated in the last 25 years, $5 billion of cash flow from our operations, from going back, from losing money in the past, in 2001, to making more in 2024. The cash that we have generated throughout that time and the cash on a balance sheet. More importantly, what do we do with that cash that goes back to shareholders? We will repurchase our shares. We have authorizations that our board has been very comfortable with us putting money back to our shareholders. We just announced today the billion-dollar buyback. You can see how much that acceleration has happened.
Just as soon as you go back to that 2018 and you look at it, that's been the growth of our company, but it's growing in a profitable way that allows us to invest back into our business and be the standard of care that we all want to be, but we also want to give money back to our shareholders and buy back shares. During my time here, I think we've netted 9 million less shares. We went from 82-ish, 83 million to around 73, 74 million shares. Net shares that we've had. It's doing this. It's being able to buy back and put it on money where our mouth is. When you bring it all together and back, that's giving you the financial framework. It's what everybody has been talking about up here today.
We have this massive opportunity with new and better technology to be able to serve our customers and give us that competitive advantage that sets us apart. We are going to continue to reliably execute and make a difference for our customers day after day and make a difference for our shareholders so that when they invest in us, they know that they are investing in a company that is going to grow and be the key leader for the future and be able to have this unique position that we have created and do it day in and day out and be able to grow in a profitable way. I will leave it with this in terms of what we believe and what we think of trying to summarize in my takeaways of what my colleagues were just talking about. It is an underserved market and it continues to be.
That competition is not other clear aligners. This is not about share shifting. This is about going after wires and brackets and making a difference. Going after wires and brackets so that they're not the standard of care, we are. That is our competition in this underserved market. We need technology. We need workflow. We need new ways to go to market so that we can make things easier for our doctors, make sure that potential patients are aware of differences on what we bring versus maybe some others. This is not a zero-sum game from a clear aligner company. This is market expansion. We are a company that believes in the market and believes in the fact that we are going to bring digital dentistry to the world, whether you're a dentist or you're an orthodontist.
With that, I'll turn it back over to Joe Hogan.
That is our story. Just a quick couple of closing slides here. Wanted to trust the digital platform. I think you can see how that digital platform plays throughout the entire company and how it has just gained momentum over the years, especially around new technology like 3D printing, obviously AI, machine learning algorithms, and all that we are driving through the business. That is 20 million smiles. We are pretty proud of it, but we think that is just the foundation of where this business can grow. I just like to end here with a 3D printing, touch us workflows. This is where we are right now. That is the next phase of Align's development. It is technology-based. It is distribution-based. It is a global business. There is really not another dental company like this in the world.
Look, and you've seen numbers, you've heard about stories and whatever, but what I'd encourage you to do, and I've been around it for a long time, think about the enthusiasm and commitment you see from the leadership team here. People have been here for over a quarter of a century. I've been here 10 years now. It's the longest job I've ever had in my life. I don't know if that means I'm doing well or not, okay? I truly believe in what the future of this company is. The best days of Align are ahead of it based on what you've seen today, the commitment of this leadership team, and as we move the company forward, I couldn't be more excited about it. With that, we're going to do some Q&A, and we'll take your questions. Thanks.
Thanks, Joe. Thanks, everyone. Just a minute.
We're going to bring some chairs up here. Can the leadership team join us? And just a reminder, we do have two folks on my team that will have mics. We want to make sure we capture your questions. Just one minute as everybody comes up, and we'll get started. All right. As we're getting settled here, why don't we go ahead? We'll start in the back. We'll move around, promise. Go ahead and, if you don't mind, we'll start the Q&A. Do we have enough chairs? Do we all fit? Close enough. Go ahead. Let's get started.
Good afternoon. Vik Chopra, Wells Fargo. Thanks for hosting an awesome day today. A couple of questions for me. One is, could you help us out with the cadence and the pacing of the revenue growth over 2026 and 2028? I had a quick follow-up, please.
I think when I look at, I'll be behind you. Okay, I'll go this way. When we look at the cadence of what we see, I think if you looked at the volume and revenue that we have as we exit this year, I think you'd see on a year-over-year basis, you're going to get to a pace that's a little bit above mid-single digits or as things continue to grow. We would expect that kits into next year. If the economy doesn't change and we don't see a dramatic change there, we'll be in that 5-15%. We'll continue to grow that. I'm not guiding for 2026. We're kind of laying out the framework of what we expect over that next three years.
Look, as our products take hold and we have those additional opportunities, and there's not a, I always kind of put the caveat out there as long as there's not a major change in the economy, recession, or other things that happen, we'll continue to be able to grow as we can and be in that range. That'll be something as we get closer to 2026 and into that timeframe, we'll give more of an update as to what that is.
Okay, thank you. Follow-up question. I didn't see anything in there about ASPs and how to think about that over the 26 to 28 and beyond timeframe. Just also curious how you think about peak margins beyond the 25%. Thank you.
Yeah, I think when you look at ASPs, just what I was describing in terms of being at some of the mix that you have and growing in certain countries that are just at a lower ASP, think of ASPs down a couple of points as a result of that when you think about over that time period. Doesn't mean, and I put the caveat and information on from a gross margin sample. Gross margin could go the other way. We'll see improvement there as we drive efficiency and so on. List price is just what it is for certain products. That's the difference there. When I look at the profitability that we have and what we're expecting to at that 25%, that's something that we want to be in. We want to be in that from a long-term standpoint of op margin.
It shows a reflection of the health of the business and the revenue that you have. Ultimately, that should show up in profitability. We are committed to getting that, maximize that revenue growth through all the different things that we have been talking about, but do it in a profitable way.
Thanks. Mary Wright, Morgan Stanley. Can you talk a little bit more about direct fab and putting some numbers around it? I guess, one, what are some of the limiting factors near-term? Are there near-term investments still that you need to make that are sizable at all? Can you quantify what that can contribute then? What is embedded in your longer-term guidance in terms of the contributions from direct fab? Thanks.
I can start with that. In terms of the investment, we're always adding capacity for investments that we have in direct fab or in previously the existing manufacturing. We're going to continue making those investments. We put the, for this year, we talked about $100 million-$150 million of CapEx. That includes some of those investments that we have and we'll continue to make that. What we will find on the direct fab, when those new products, like I was describing, when those first come out, you don't have the scale yet. You haven't scaled the manufacturing process. What's your throughput for that equipment? And what's the resin cost that we have? As you have more volume coming through, you can end up scaling both of those. Initially, 2025, it hurts our margin. Into 2026, it still hurts that margin on those particular products.
As you get into 2027, when you start to scale and you get through, you're using for retention, you've got other products that are maybe more difficult to manufacture under traditional manufacturing, and now you direct fab them, you start with those. Ultimately, as you're making aligners, now you've scaled that and that becomes a good business. The other pieces of it is from an overall margin standpoint, we're mindful of the fact that there's a scaling process that you have to go through. We know how to do it. It's just a matter of scaling that up and being able to be at. Not to mention too, when you have some of those new products, we talk about ASP and so on, that at the very least will help us hold our ASP.
In many cases, there'll be unique products or unique applications that those doctors could do that might even be at a higher ASP as well. That helps offset some of the additional costs, especially as you scale. Great.
Thanks. John Block from Stifel, maybe two. Joe, the first one for you, a ton of new products, right? Simulators, some pros, some video, oral health, and a lot of R&D dollars that go into that. You're showing conversion that occurs. Any changes, sort of the marching orders to the reps or from a commercial strategy to help incentivize and make sure that all these features and functionality, IPE, I can go on and on, is being utilized, utilized to its fullest extent to help sort of drive that ultimately that top-line result?
Hi, John. It's a good question.
I think I started in commercial in my life too, and what you're asking is really important is how are they incentivized to really go forward? The great thing is, and Frank, and Simon, and David can join in here too, is we have to train our salesforce really well because what you could see is very sophisticated tools that we have to bring forward. There's a number of constituencies that they're talking to, right? You're going to be talking to lab techs, you're talking to doctors themselves, you're talking to hygienists or whatever. There's a different tool in different areas that all comes together with that digital platform and what we want to make. The main thing, we reward salespeople on being able to sell product and revenue and product. The thing is to make sure they have the proper training in place.
If we start incentivizing them on, hey, how you're trained or what you know, whatever, but we'll watch very closely in a sense what tools they use, test them and how they're cognizant in the different product lines and whatever. That's how I want to end my talk too is honestly that that distribution force is so critical. What we sell is a very sophisticated product targeted at a sophisticated audience from a clinical standpoint. We have to have top-of-the-line training and people to be able to bring that home.
Very helpful. Maybe to shift gears, and John, I do want to go back to ASP. It's probably the number one inbound I get. You had this slide, 2018, I think it was 2018 to 2024, FX adjusted, ASP was flat, I think it was 12.95.
You're talking about maybe a 1%-2% disconnect between on ASPs going forward. Should we be cognizant that it's a little bit more pronounced in the near term? You've got IPE, $500. You've got DSP, Simon said coming to EMEA, right? The incrementality of those lower ASP products are more pronounced in the near term. When you get to 2027, 2028, you'll be commercializing direct fab. I'm guessing some of those offerings might have more of a premium feel to it. If it's 1%-2% over that four-year period, is it a little bit more acute in the near term? It sort of unwinds as we get to some of the premium offerings. Thank you.
That's a fair comment. I would look at that and say, look, some of that DSP and other products, they're at a lower list price.
That's what it is. You're right about that. As we have more premium products coming in with some of the direct fab, those are mostly going to start with some of the comprehensive cases. You will see it show up in the comprehensive cases at a higher list price. I think that's a fair statement. I think you would also then see some of the offset in volume because if you're growing like that in DSP and some of the others, because that revenue number that I gave for this year and kind of how we're looking at stuff, revenue for this year, $3.5 billion-$5.5 billion, look, you can model how you want with ASP and so on.
If you take that approach and you have some of the newer offerings that are lower ASP, we'll get more volume and we'll be able to generate that revenue and ultimately be able to generate the profitability. When we talk about holding the 22.5% for this year and so on, that's taking all that into account. It might be at that initially at lower ASP just because that's the mix that you're facing in the short term.
Hi, Mike Cherney from Leerink Partners over here. I guess I'll just ask one kind of big picture question. Obviously, both medium-term guidance as well as long-term guidance assumes an acceleration of case starts. You said at the beginning, early on, your biggest competition still remains brackets and wires, not a big surprise.
As you think about what's embedded in your build on case starts, knowing it's a very wide range, how are you thinking about the clinical education and clinical advancement of clear aligners relative to kind of market awareness across various different markets? Do you need a sea change from kind of the scientific community, from the user community in terms of getting back to those more elevated case start levels? Curious how you're thinking about the awareness side of where clear aligners go.
Yeah, Michael, it's a good question. I'd just say there's many touch points to make this happen. It's one, you have to start with the portfolio and capability we talked about with the uniqueness of our product line and the efficiency.
You're going to knock down as many as what I call the frictional barriers at those accounts that they'd want to take that step and go to digital, which is a dramatic change from doing analog together. You could think you could run into the academic community and how do you train orthodontists or whatever. We've made good progress in that area over the last five years in the sense we have several universities we work with today that will offer maybe do 20-40 Invisalign cases as part of an orthodontist training going forward, which is kind of a groundswell. One of the critical things we run into though is doctors graduate with about $500,000 of debt. If they go into the marketplace, more than likely they're going to do wires and brackets for five years. That's the workflow that they have.
They come out, they buy a practice, they start a practice, they want to move into that. We're going to try to find ways, and we've worked out with DSOs to work in different ways of being able to have digital practices that will be set up that doctors could go into and help to fund those. We, first of all, starting with DSOs is a good way to go about that. Somehow of getting those digital practices in front. If we wait for academia, we'll all be dead in this room. Okay. It's just many of those facilities are run by people that are around. They're 75 years old. They've been doing wires and brackets for 50 years. They don't really want to move from it. We're going to have to move from a market standpoint.
Ease of use of technology, make it line of sight for doctors to say, "Look, I think I can do the digital thing." Also be able to work with organizations that have mass to them to be able to set up digital practices that orthodontists can eventually evolve to. I hope that helps.
Great. David Saxon from Needham. I just had a follow-up on direct fab. I'm not sure if this is for Emory or John, but I think in the past you've talked about the actual mold being 70-75% of the actual clear aligner cogs. Today, there's obviously other benefits, freight, labor, etc. Once direct fab is scaled, what percent of today's cogs, clear aligner cogs, are ultimately taken out? I just have one follow-up. Where's Srini? Oh, Emory. Emory, you can do that.
Okay. I think, I mean, I think you mentioned a high percentage of total cogs. Really, the mold being eliminated goes into the material cogs. That is not the whole bucket. It is just that one bucket, right? I think if you, it is hard to speculate, but you are probably talking in that bucket, low single digit to or high single digit to low double digit reduction on the material side.
Okay. I guess anything on freight labor overhead?
I mean, I think we will see the, at this point in time, it is hard to nail that down.
Yeah, sure. Okay. My second is just for David. I think if I saw the slides right, it was 51% of volumes are in the GP channel. Is there anything specific to the APAC region that is allowing you to kind of engage the GP channel in that way? Or can you kind of replicate that in the Americas and EMEA? Thanks so much.
Yeah, I just think a point of caution just with those statistics because in APAC, we have a much smaller percentage of our customer base that are specialized orthos. We have a lot of GP orthos. So just when we make that breakdown, it's a lot represented by GP orthos. So it's kind of hard to make that direct comparison. As I said in my presentation, we just run, if you look at our growth programs between new doctor onboarding and then the growth programs for existing customers, that's really how we're driving that increase in submitter base and utilization.
Hi, everyone. Over here, Brandon Vasquez from William Blair. Thanks for the question. Maybe first I'll start with for the commercial heads in the regions. A lot of you had made comments that this is a similar playbook we've used before and you're kind of executing on the same thing. As Joe had showed out to us, you guys are kind of entering a new era where you have the broadest portfolio you've ever had, most clinical applications, most price points. The question is, does anything change from here? Are there any incremental new strategies given that you have, you're kind of entering a new era of Align from a commercial perspective?
I think a lot of it is around the sales and doctor training. You have your core product portfolio in Invisalign, as we talked at length about today. Obviously, the iTero Lumina is a huge part of the platform as well.
It really is getting the enablers that help with conversion and drive practice efficiency so that the practice can really take the benefit because they're still under staffing pressure and whatnot. You really gain some benefit with all the enablers. Then the ClinCheck component, which is arguably, I think, the most impressive, moving from weeks to minutes and live updates, having the doctor's personal preferences, having their own signature on every case, essentially, is really where the critical path is from a commercial perspective and ensuring that doctors are engaged, leveraging that ClinCheck, all the pieces of the platform that drive efficiency and those enablers that are in there. That's where the focus is: training, salesforce, doctors, and ensuring that we're partnering with our customers.
Okay.
Oh, hi. It's Steven Belichet from Mizuho.
I still think about some of the cost of manufacturing, maybe on a per unit basis. If we think about just Invisalign case, cost of manufacturing maybe $350, $400. I guess the question I really have is if that does come down a little bit, what's the mindset philosophically on whether that just falls right to your pre-tax profit line, or do you use that maybe to bring down Invisalign pricing and ASPs to drive more volume growth? Just curious how you think about that longer term. And to get to that 15% plus volume growth, do you have to, I guess, what's your mindset on the pricing versus just the macro driving most of that? Thanks.
Yeah, I think you saw in John's chart, and I can let John pick that up too, is how we've, Steven, how we've modified additional aligners.
Now we have three by threes, our biggest product, our moderate products in there too. That's the way we've addressed this. Customers ask and doctors and patients ask for different things, and we won't modify our portfolio in order to do that. How we use average selling price, at times, I think in the future, we might be pressured somewhere on average selling price or whatever. We sell a lot of value with our product line. Our competition just comes in on price. If a doctor's doing 20 cases a year and someone comes in with a couple hundred dollars different, they'll probably make a change. That's nothing that's going to be material to us. I don't think we can chase those kind of little things and have them force our price down. I want our people to sell value.
You can see with 3D printing, we're going to have a lot of value to sell. Underneath that, though, we'll have an incredible vacuum form line that's almost zero touch on ClinCheck. It's probably the most efficient thermoformed aligner and the highest quality in the world. I'd rather play the game with that end than the upper end of our portfolio. That works its way through. I see that being a specific way for us to go about that, right? We'll sell high-end and we'll sell an efficiency product too. We don't have to match a higher quality product with a lower quality product because of price. It'd be the worst thing to do. Hope that makes sense.
Thanks. Good afternoon, Jeff Johnson Baird. John, just starting with you, I guess. On the 5-15, I just want to make sure we're clear on this.
I think you said it's kind of independent of macro, of current inflationary rates, other kind of issues. What would it take then to get to the top end of that versus the bottom end of that? If macro isn't the driver of going from 5-15, what goes right to get you to 15? What maybe makes you perform at the lower end of that 26-28 range? I have one follow-up. Thanks.
Yeah. To be clear on the macro, I'm just assuming it doesn't change from where it's at. You can think whatever you think of the macro now. I'm just saying it doesn't change. When you think about what, as we operate in this environment, looking at what we can control as we have new products that come out. You have mandibular advancement with occlusal blocks.
You have IPE. You have new ways to go to market with some of the stuff we're talking about, the ortho restorative and so on. Those help us grow, be able to grow our business and be able to drive more volume and so on. It is continuing to do the things that we're doing to be able to operate within that environment. If the macro, and we're seeing in some countries where the macro, it's better. I mean, you're seeing double-digit growth in various countries we have. We talked about kind of mainland Europe being better than what we've seen in the past. Just most recently on earnings, we talked about the Americas and specifically in North America starting to get a little bit better.
We want to continue to drive that with some of the products and things that we're doing, go to market and so on, partnering with DSOs and so on. If some of that hits and macro stays the same, we'll operate within that model. Some of these take off themselves. We can operate further into that model. If you get macro to at least not be as negative as it is now and give us some more stability, meaning interest rates a little bit lower, a little bit better consumer sentiment, we'll be further up into that 5-15% model .
All right. Fair enough. David, maybe for you just on China, I feel like I'm feeling maybe a little better on China after today. Maybe that's a kudos to you on that.
I guess one thing I still want to understand is in a VBP world in China, you talk about consumers and docs are still willing to pay a premium for Invisalign. I understand that would be in the private market and VBP is in the public market, but we often see public market pricing kind of bleed its way into the private market over time. Can you continue to get that price premium even in tier one cities in the private market over the longer term if VBP is going to bring all these prices down to one kind of competitive bid level if you want to think about it that way? Thank you.
Yeah, look, I've had a chance to watch VBP unfold in a prior life and seen how really the secret to VBP is playing the portfolio and understanding that there will be one product that you probably have to bid competitively on, but then understanding how you leverage other products in your portfolio. There are a lot of different scenarios that we're kind of looking at with how VBP may unfold. There are some examples, as I said, that I've seen in my prior days in Medtronic and I've seen in the dental space how it's playing out for certain suppliers in other areas of dental. We're just modeling different scenarios and kind of thinking through how we would strategize the portfolio. It's a portfolio. Those who are successful, it's a portfolio play. Yeah.
I think we have time for maybe one more question. Great.
Thanks so much. Jason Bednar, Piper Sandler. Start first with Joe, and then I got a follow-up for John. Joe, you mentioned you've been here 10 years. You've kind of guided, it seems like, Align from Align 2.0 to Align 3.0, just based on the slides you had up there. Digital's prolific. That's kind of in the realm we're in the midst of right now. I guess as you think about your own LRP with yourself personally, how are you thinking, you and the board thinking about succession planning? Just because we are at the point now and I started getting the question of what's next for Align. We've laid out a lot of what's next for the company. I'd love to hear what's next for you and, again, kind of what's beyond you as well.
Jason, I mean, obviously, I'm not a young character anymore. I've been around for a while. The board and all of us, we have an active CEO succession planning system. We revisit it almost every quarter. I feel good about the process and the opinions and the people that are on board with that. From my standpoint, look, there's obviously this Align 3.0 as we refer to. I really feel we're on the crux of the next phase of Align. I want to make sure that's solidly in place. You can see we have a good team here, a very good team. I couldn't ask for a better group of people to work with from a commitment standpoint and also from the board to me and I think realistic expectations of where my career is at this point in time, the team, the momentum we have.
That's really what we all look for. There'll be a point where I say that's enough. It's not right now, but obviously that's coming, but there's a good process behind it, I can assure you. Very helpful. Thank you.
John, on capital allocation, I know we all saw the share repo. That was a big focal point in the slides. You've also done M&A in the past. We've seen other things like investments in DSOs, OSOs. I guess we can't predict M&A. I guess more is the investment in the DSO, OSO side still something that you're committed to being a part of the overall capital allocation plan? Should we expect more of that or an acceleration in that? The secondary part of this, as we look at DFAB scaling, is that going to be something that requires greater CapEx investment from the company? Thank you.
No, it's good. Look, first and foremost, when we're investing, we're investing for a return that's right for the business. I always look at it as this is not an or discussion. I don't think of it as this or that. I think of it as an and discussion. When we talked about the capital allocation and the free cash flow that we generate and so on, one, I want to be able to use that cash and what we're doing to better help drive the business, grow the business, drive top line, drive efficiency and productivity and so on, new products and other things that we invest in the business. There have been some acquisitions that make sense. We used our cash for it, Exocad being the biggest, but back in the day, even Cadent before that, and then most recently with Cubicure.
We use our cash for that. We are doing all the other things to be able to grow the business as well as that. CapEx from the standpoint that I do not see an extraordinary amount in the short term. I think it kind of has kind of a level amount of CapEx that we need to spend for expansion. In this case, instead of doing the vacuum form expansion and other things we are doing, a lot of that is going to be supplemented and put into the Cubicure and the machines that we are going to need to do the direct fab. It is not like it is more.
It's just a different type of spending to be able to add that capacity because in the end, we're committed to growing this business, utilize the cash that we have to be able to grow and do things in a mindful way, and then return that cash back to shareholders with our buyback. I hope you saw that come out. I mean, we think about the growth and the productivity and the margin opportunity because it's so important to us to generate the cash that we do because that gives us a lot of flexibility, flexibility for new products and development, flexibility to be able to give back to our shareholders based on where we think a good investment would be, and that's through buybacks.
Hey, just on behalf of the entire company, thanks for coming. We were looking forward to this. We hope you found it valuable.
I think if you can sit back and maybe just take off your business mask for a second and think about just you probably walk in here and you see things personally from a healthcare standpoint. It might be appealing to you in the sense of moving your teeth or Želko's slide. You can't get that out of your head about how you grind down enamel or whatever. I think as you think about Align as a business opportunity or whatever, think about it also from a consumer standpoint. We really feel we're on the right side of this. We have a lot of technology to offer, and it's both from a consumer standpoint and convincing consumers, but also lowering that frictional point with doctors and moving our product through. I feel we're on a really good plane and really changing industry. Thanks.
Thanks for your questions. Thanks for your time.
Thanks, everyone. Please join us in the reception area for some beverages and snacks if you have time to also do a scan.