January 12, 2024

48 providers of clear orthodontic aligners, comprising 36 Invisalign providers and 2 former providers in the United States (25 orthodontic practices and 13 dental practices) and 10 Invisalign providers in Brazil, representing more than 6,700 Invisalign case
starts in 2022 (6,308 in the United States and 417 in Brazil)

REPEAT SOURCES 37, comprising 29 in the United States and 8 in Brazil from OTR Global’s September report

INTERVIEWS Dec. 13 through Jan. 9

Invisalign Maintains Position

Despite some seasonal weakness, U.S. Invisalign case starts mostly met or exceeded providers’ expectations for 4Q23 and earlier projections for 2023, and providers in the United States and Brazil expect higher yy growth in 2024 as economic conditions improve.

• U.S.: 2023 Invisalign case starts flat–down slightly yy (vs. up 1%–4% forecasted in September but consistent with repeat sources’ figures); conversion rate trends weakened slightly during past 90 days because of patients’ financial pressures

• U.S.: 4Q23 case starts met (26) or exceeded expectations (6) for 32 of 37 sources; starts up (11) or flat (14) qq for 25, affected by seasonal softness for some

• U.S.: 2024 Invisalign case starts expected up 4%–7% yy, supported by expected economic improvements

• U.S.: ALGN remains dominant clear aligner manufacturer for majority of sources; ALGN gained share vs. metal braces for 7 of 25 orthodontic sources in 2023

• Brazil: 2024 Invisalign case starts expected up (4) or flat (4) yy for 8 of 10 sources; teen use up during past 90 days