Align Technology‘s Invisalign is a revolutionary method to get you the smile you want through 3D printing. It is also a hugely popular process to go through, a $4 billion revenue company, and one of the largest 3D printing applications in the world. Perhaps two million inserts for dental aligners are made each day. As an industry, we would only need another Align or two in order to experience significant growth. The central innovation of Align—to properly allow for teeth alignment through a progressive treatment using clear custom silicone aligners made with 3D printed intermediates—changed the way people receive orthodontic care forever. It disrupted an industry and created a completely new business. Subsequently, Align has developed 3D scanning technology, materials, methods, and processes to improve their procedure and shore up their lead. The company also acquired Cubicure, allowing Align to use their Hot Lithography capability to 3D print more viscous resins for making aligners directly through 3D printing, manufacture other devices like mouth guards, and expand into new treatments. Align’s example as a successful business that uses 3D printing looms large over our industry. But, can we do something like this again? How can we replicate this success? And what is it that actually enabled Align to succeed?

To find out more, we interviewed Align Technology’s Srini Kaza, who has been at Align for over 26 years. Overnight success sometimes takes decades of dedication. Kaza started as a manufacturing process engineer, and moved up to Director Manufacturing Process Engineering, Senior Director Emerging Technologies, Senior Vice President Product Innovation, and is now Executive Vice President R&D.

Kaza mentions Align’s “smile-changing technology” as giving people “the smiles they want and deserve.” Comfort, convenience, and the digital workflow, as well as efficiency for practices, are key elements of their offering, leading to 20 million Align patients. Looking forward, the company is focusing on “our strategic growth drivers, which include international expansion, general practitioner (GP) adoption, patient demand; conversion, and orthodontist utilization.” He sees the company as being successful through making a “seamless, end-to-end experience and workflow.”

The most talked about innovation in direct aligners right now is direct aligner printing. What does Kaza think about that? And will Align ever look beyond vat polymerization?

“We are exploring direct printing but at the same time, we continue to invest and innovate in our current process. For the foreseeable future, we believe direct 3D printing and indirect printing are going to coexist in a symbiotic way. We believe there are several opportunities with direct printing. The Invisalign Palatal Expander System, which became commercially available in the US in late 2023, is Align’s first direct 3D printed device, based on a proprietary and patented technology. It is a revolutionary, clinically effective approach to expansion that avoids the challenges of traditional palatal expander appliances. We are looking at other opportunities with retainers and other devices as well.

“We continually look at new technologies whether they are beyond vat-based polymerization or other technologies beyond polymerization. Our approach is to look for technologies that can solve key problems in our production and for our customers and patients. We are willing to explore those things that serve that purpose.”

I like the nuanced view here; it’s easy to imagine that direct printing is the one and only future for aligners. But, if we look at the scale Align operates on, and the many considerations, adoption could take a considerable amount of time. But, what about 3D printing as a whole? If Align is looking at the market and the technologies available there, how is it doing this?

“We believe 3D printing technology will play a significant role in helping meet the increasing demand for clear aligner treatment and a customized end product. 3D printing technology has come a long way, and it continues to offer opportunities for more innovation. Its potential to bring material advancements to industries including dentistry and orthodontics has just begun. We believe continued research and development in 3D printing will bring even more customization and efficiency to the 3D printing process in the future. We intend to continue to work on solving the scalability opportunities we have around the material, yield, and throughput.”

It’s clear that Align is looking at additive in a holistic way and working to improve many aspects of the technology. But, now that it has Cubicure, it may be able to take a particular direction that others can not. What exactly are the company’s plans with Cubicure? Kaza says that it will help strengthen Align’s digital platform, support the strategic innovation roadmap, and scale its 3D printing and materials capabilities for Align’s 3D printed product portfolio, “which now includes the Invisalign Palatal Expander system, a safe, comfortable and clinically effective alternative to traditional palatal expanders.”

“The acquisition of Cubicure will strengthen Align’s existing intellectual property portfolio and know-how in direct 3D printing of appliances. Cubicure’s patented Hot Lithography technology uses a special heating and coating mechanism that enables the processing of highly viscous resins to produce particularly tough and temperature-resistant polymers. This high-precision 3D printing process facilitates the unprecedented additive manufacturing of resilient components with an astonishing first-of-its-kind material quality performance.

“We intend to use Cubicure technology to print medical-grade devices that will directly go into the mouth. Products for dental applications need a unique combination of high modulus and elasticity, aesthetic properties, high safety profile and scalability. We believe Cubicure’s process gives us the ability to create and process such polymers.”

More materials, higher performance, and coatings could therefore give the company a distinct advantage. In time, it could achieve direct 3D printed devices with high performance properties. Maybe they’re looking at dentures, temporary crowns, night guards, or mouth guards? There are many directions that Align could branch out into, given its current lines of business and capabilities. I of course thought of Cubicure’s ability to, perhaps, print support and build materials differently at different wavelengths and automatically remove them, for example.

“There are multiple concepts around using multiple materials, possibly multiple wavelengths, to optimize prints,” Kaza said. “Some of these might be possibilities in the future but would also increase the complexity. These concepts have to work smoothly at a massive scale for them to be production ready. We intend to continue to look at these opportunities.”

Innovating while having one of the world’s largest 3D printing operations is obviously quite a bit harder than just having a bright idea. Indeed, the sum total of these bright ideas add up to, once perfected, just a part of that all important workflow. Here, Kaza points to easier 3D scanning with Align’s iTero intraoral scanners as an innovation that is improving the experience. Treatment planning is a very important part of what the company does, as it helps to “improve treatment predictability, flexibility, planning, clinical preferences, and 2D/3D imaging, including digital tools for faster and better case set ups with more accurate final tooth positions.”

It’s clear that Align wants to extend its lead over clear aligner competitors. Meanwhile, new materials and improved workflows could also significantly extend its product line. But, the company has to implement these innovations in a critical high scale environment. That would seem like a very challenging thing to do. I’m very enthusiastic about Hot Lithography and the safer, stronger, higher performance resins that can be enabled by that technology. Having Cubicure gives Align a clear edge. If the company combines its scale, workflow, and this unique technology, then it could lead to entire families of new products. The company’s Palatal Expander System already expanded its products to children, and a new kind of treatment that could preempt later more invasive treatment. More directly 3D printed products like this would extend its current 3D printing infrastructure to new products at little in the way of marginal cost, beyond the innovation and approvals initially needed. That kind of a platform approach, if extended, could mean that it would be cheaper for Align to develop and deploy new dental innovations than others. Rather than a product company, you could then see the business, with its flexible 3D printing capacity as a kind of Salesforce or AWS for dental.

If looked at in this way, Align as a platform could continue its lead by buying, licensing, or enabling innovation, and then distributing flexibly through the biggest group of pent-up demand in patients and a network of practitioners. There could be a real strategy here that leads to a technology deployment platform, manufacturing capacity, and workflow that can consistently win at scale. If the company could pull that off, it will be sure to continue bringing a smile-changing technology to investors as well.