I'll tell you what, I'm so excited today because I looked at my schedule and I thought I was podcast interviewing Joe Rogan. And then I come to the studio and it's even better. It's Joe Hogan, the president and CEO of Align Technology, the company behind Invisalign and Itero and one of the most accomplished executives in global healthcare technology. Um, Joe and I have been on a similar path. I'm in Awatuki, southern Phoenix, next door in Tempe where I went to ASU and we both founded our companies in 1997 and we both went live with customers in 1998, Dunneltown and Vizline. So I've been watching you and from our first podcast, I mean really you've been a serious mentor of mine. And that's why because of you out of the 12 specialties, the only other specialty site I started was Ortho because I really believe that that was a separate community. But we plan on ruling out the remaining 11 before the end of this year. But before joining Align in 2015, he served as CEO of ABB, a $40 billion power and automation company based in Zurich, Switzerland, and spent 25 years at General Electric. He used to be in the same room with Jack Welch for years at MBA school. Whenever we said Jack Welch, we had to make the sign of the cross. And the guy just changed the world including eight years as CEO at GE Healthcare where he more than doubled revenues from 7 billion to 16 billion. He holds an MBA from Robert Morris University which is almost as good as ASU and a BS in business and economics from Geneva College. Unbelievable. Joe, seriously it's just unbelievable to have you on the show. You've led some of the largest companies in the world. What drew you to Align Technology and what has surprised you the most about the dental industry since joining?
Well, it's a great question really. The first part of that is, you know, when I left AB, I came back, I had some marital issues and I quit that role after being in five years running ABB and I just came back to kind of get my life together and figure out what I was going to do next. And that worked itself out in its own way. And I was looking for a role. It was about I was out of work about a year, year and a half. I was looking for a role and there were several companies back in Europe, heavy industrial companies like I was used to that were interested in me and I have a friend Steve Patscott. It was my HR director. It's a long answer for you because it's hard to believe that I came here at that point in time. Jen and I were talking about that this morning, I stood back and said, what am I going to do? What makes sense? And so I looked at those companies in Europe and I thought, I might want to go there. And then this came up. Steve Pascot called me. He was working for Spencer Stewart and said, 'I got a job for you.' And Align Technologies, Invisalign's looking for CEO. And I said, 'How big is your business?' And he says, '700 million.' And I said, 'Steve, it's kind of a small business.' And I said, 'I've known Invisalign. Goodness, I can remember exactly when I heard about Invisalign.' I thought, 'Wow, if you can move teeth with plastic, who would ever want metal?' And I said, 'But Steve, it's kind of small. It's been around for like 15 years.' And it hasn't, you know, it's not really as big as it should be. And Steve said to me, he said, 'You know what? You've already done the industrial stuff. You've never worked in Silicon Valley. Why don't you go answer that question yourself? Just go run a company and see if it makes sense. If you don't like it, just quit.' And I thought, big change in my life. And I don't want to move back to Europe. My parents were over 80. And I had three kids that I had to take care of in the States, too. And so, I decided to just try it. And I fell in love with this business, and I'm still in it. It's everything you'd want from a business standpoint. It has sophisticated distribution, unbelievable three largest 3D printing company in the world. All the mathematics and algorithms you have to write to move teeth and do it properly. I grew up in GE plastics was my first job. I used sold plastic. So I have a polymer science understanding and the sophistication of polymer science that you have to have to know how to grab teeth and move teeth. And so it just captivated me. So, I've been here, this is the longest job I've ever had in my life. It'll be 11 years, Jen, in June. And I just love the company. I love the technology and I've really enjoyed my time. Since I graduated from Dallas 187, you already had all the big brands of Colgate and Crest or Listerine and all that stuff. The only global brand that I've seen come up is Invisalign. When I would lecture around the world, I'd always take my boys with me and I don't care if you were in Cambodia, South Africa, Malaysia, China, didn't matter where you were, you'd be sitting at a restaurant and if it came up you were a dentist, they'd say, 'Oh, do you do Invisalign?' And it's like they knew that word in Tokyo everywhere. I've never heard another brand. My god, that's a big brand. And then that polar polymer science makes sense because I remember when all your patents expired and all the knockoffs came out of nowhere. And you know we have OrthoTown and the orthos always say yeah but there is it's their plastic it's the material, it's not price, it's not cheap. There's a massive difference in your polymer. That's correct.
Than all your knockoffs even though it's not patented. So why is everybody saying that? I mean they're all saying that.
Yeah. Yeah. Well in plastics, maybe not to take you too deep in plastics, you always have this kind of dichotomy, right? You want something ductile and impact resistant but you also want something strong and hard. And what our team came up with was not one polymer. Knowing that you needed those two qualities, the softness to adhere to your teeth and the polyester itself, the hardness to move those teeth, came up with what we call smart track, which is two layers of polyurethane on the outside and a layer of polyester in the middle. Polyester would be like...
Yeah, exactly. But you know, polyester is what you have in soda bottles and those kinds of things, right? And so, but it was the co-extrusion of those things, making sheet and co-extrusion of making that, and the teams had to do a lot of work in polymer science to figure out that those were the two magic polymers to put together to make it work, and that changed the cases we could do, how fast we could do cases, and how accurately we could do cases.
You how many? I mean, I don't even, I wouldn't, I couldn't even imagine how many different customers you have. How many orthodontists and dentists use your product?
Yeah, a quarter of a million. My god, that's the population in Tempe, isn't it? So what are the most successful Invisalign orthodontists doing differently that every orthodontist should know about?
Yeah, we call them digital orthodontists. They actually are over 80 to 85% to 100% Invisalign. And what I think what we've learned through that is that productivity. I think often orthodontists think about how much money they pay for wires and brackets and Invisalign that you referenced, and you know what we do is it's chair time. The faster you can move patients through that chair time because that's the real center of cost in an organization. So the doctors that utilize the orthodontists that really utilize Invisalign over 80% have a much faster throughput. Most orthodontic offices, what is it, 25% of the time is a wire and bracket issue and a patient has to come back and fill the chair time or whatever. They remote monitor these cases now with virtual care or other kinds of programs. So the patient doesn't have to come back all the time. You can clear them to go to the next aligner or whatever. So the short answer to your question is just raw productivity: how many patients you can actually get through your practice in a period of time is almost 3x then versus just wires and brackets. So it's that productivity piece.
Well, I'm so glad you said that because the one thing I had to learn the hard way is you know, I learned how to do ortho. I went to Brock Rondo and Jack Sheridan and who's the one who just passed away? Oh my gosh, he was the only board certified orthonist. He came from the program at University of California, San Francisco, than he was at Detroit. He was the only but anyway, but you know just for easy math let's say ortho 6000.
But the orthodontic appointments might be 15 minutes and then the dentist says it for 6,000 and his appointments are a half hour.
Okay. Well you just had twice the overhead. So if orthodontists are running at 50% overhead which they're not, you just did it for a loss.
I mean it time it's people time and money. And if your people only place an implant once a you know once a month, that's kind of scary. I mean you know in dentists you know we do fillings and root canals and crowns and extractions all day every day. But yeah, but you know excuse me but I think when you think about orthodontist and what I just said about your time whatever, I don't want anyone to have the opinion I think that's easy. It's very hard to change workflow and process, right? And especially when you've been trained as this and you've been doing it for years or whatever to completely reorient your staff, it's a very difficult thing to do. So I don't sit back and judge or donest like they're why in the world can't they do this, right? I think it's a hard transition, but what you find is when you make that transition and it's a year and a half of hard work to do it, then you're at that level you just talked about where you have that great productivity, you have the flow, patients are trained, but it's a walk through the desert for orthodontists to make that change. And I don't want to make light of that.
And we're both MBAs and specialization was a big part of economic growth. You going all the way back to the 32-year-old Scott Adam Smith and Sure. And my gosh, who wrote that book, the the um the same year is about the wealth of nation. 1776. And in 1776, another 32-year-old Scott wrote another document you probably heard of, the Declaration of Independence. That's right. So it was free markets and free people collided and the world never stepped back. But specialization was a big part of that. And dentistry is now 12 specialties. And that was Adam Smith in the pin factory. Remember wealth of nations? That was the best illustration of what you just talked about. Absolutely. And my gosh, you know, I love it when you get out of school there's 12 specialties. I think the first 12 years out you should pick a specialty and own it, but not to do it yourself, but just to learn how to communicate with an orthodontist and an oral surgeon and a periodontist. And even though we have 600 online CE courses, I always tell dentists that costs like $35 something. I always tell dentists your best CE is just call your referral and say, 'If I'm gonna give you all my ortho cases, can you at least teach me orthodontics?' Yes. So because I noticed that before I learned how to place implants by Carl Mish and the mission too, I would never recommend a sinus lift and all the, I thought these guys are quacks, they're crazy, they're butchers of Langanger. But then as I learned all about it, then it's like I'm never going to do a three-year print. So, power is knowledge.
It's an evolution of that knowledge, like you said, and how it builds on each other, which is I think that's kind of cool.
And the other thing is, um, when you do repetitive tasks over and over and over, it can lead to burnout. Yes. And sometimes after a while, after 10 years of dentistry, the only thing that was really fun and exciting was the patients, meeting all these new people, and learning new things in dentistry. I mean, when you're first out of school every class you want to take is on how to do a filling and a crown. And I think just taking one specialty like you know even if you say well I'm never going to do that. Well you your dental team does have 12 specialties, just learn one. But find someone in person, find someone in physical that you can go meet at Mio's for lunch and that can teach you and then all the other stuff. So, how is Align using AI across this product portfolio? And what does that actually look like in a clinical setting for a solo practitioner versus a large group practice? And be careful when you say AI because about half the dentists on Dental Town do think it's going to take over the world and ruin everything. You either think it's the Terminator and it's gonna replace all our jobs and we're all gonna die, or you're like me where I think this is going to be one of the, I think this is going to be to dentistry what digital scanning did. I think AI will be bigger than digital scanning or about the same effect or the internet? I mean.
I think those two intersect or did you take the digital scanning in AI helps to really improve that experience the depth of knowledge the breadth of knowledge so it fits in there well.
And isn't that why you bought it to kind of open the front door to digital scanning?
And as it opened your door and then you added AI so tell me everything you think how AI is going to affect orthodontics and Align but let's start with the iTero piece too because it's interesting when my predecessor Tom Prescott bought iTero. It was called Cadent at the time and thank goodness he did. He took a lot of grief for it in the marketplace. They discounted our stock because of that move. But Tom had really great insight in a sense of what it was going to lead to and why that was done. And so when I took over that business it was about $30 million just in Israel, right outside of Tel Aviv, Israel. And in my GE days and ABB days, I've had businesses in Israel my whole area. So I kind of know the technology and the culture there or whatever. And when I first went in there it was $30 million business, you know kind of like a startup in some way, and today it's a $780 million business. And you know we have it started with kind of like a PVS impression machine but then it evolved to a point where it's actually a diagnostic right. So when I started and this is probably more than you want to know, when I started here it was about 95% PVS impressions and 5% scans, and today it's 97% scans and 3% impressions. In 10 years roughly, that technology shift is amazing. You think about at one point in time we were moving more data than Netflix if you go back 10 years ago because of you'd send a PVS impression in, you take a CT scan, those CT scans were my old GE CT scans. So we sold for medical piece. So you take a physical of that. 7% of the times it didn't work. You have to ask the patient to do it again. Then you post this, then you send it to the doctor. The doctor had to type in what it back to us. We would type in it was a digital sequence that was kind of sandwiched in between this big analog piece. And today it couldn't be more different. Right. You scan it.
All that. Yeah. And now today, 25% of our cases with IP, it's Invisalign protocol programming. It's touchless. You scan, we use the doctor's protocols that they want to use. They've used on different cases. We'll show the doctor what that looks like. They can make changes on 3D control. It's like Photoshop, right? The case comes up and you make the changes and we send it on to manufacturing. Just in 10 years. It's a, you talk about then now there's machine learning in that which is a subset of AI that we talked about before, but AI is going to make that even better based on your question as we go forward in the next even three to four years you'll see a big difference too.
So I'm only I've only had AI programmers on my team for three years. How many have you had? You've had them for over a decade.
Yes. So when you qualify AI as machine learning which I do, and remember we're a technology company and the way we move teeth is all digitally, right? We have to build a case digitally and then we have to have the plastic aligners actually follow the teeth and move those properly and whatever. So there's a huge amount of machine learning to say where what machine learning basically how would you use that I can see your eyes right. So we've done a case or we've done let's say when I first came I think we did we were on like our six millionth case or whatever. So you take machine learning in and you'd say, okay, we got to have a class one. We've gone here's a class one. Here's how with a machine learning standpoint, you extract the data. Here's how these teeth move and how well do they perform. How did the case end up? And you can compare all those pieces. And now with AI, it's kind of an aggregate of machine learning. You can still take those algorithms and all use the machine learning. But in an AI level, you have the algorithms actually dig down and answer those questions that have been defined by machine learning down below. If that makes sense.
When you say 85 to 100% Invisalign for some practice, can all orthodontic cases be done by Invisalign? I mean 100% is a big number. Is it 99.9 or 95 or 90 or 80? Where would you put the number?
I would say just intellectually we could argue it's 100% with IP Invisalign pallet expander that takes the place of a pallet expander that you turn a crank on. We qualify to do any case that's out there. And so we have doctors that don't use wires and brackets at all. But I can't sit here and tell you that in some cases it might make more efficiency or sense or whatever to use the wire and brackets on these fringe cases on the outside. I think as an orthodontist you just have to describe how far you want to use the portfolio.
Do you have how many? Well, first of all, I'm just curious. What percent of your business is US Canada versus the rest of the entire world? And what percent of your business orthodontist or 100% Invisalign?
Let's say 5% of our business is 100% Invisalign.
Okay. So 95 see it as hybrids in some way. And then you have general dentists that are doing this and you have orthodontists that are doing it too. But it's a fringe case. It's still at the tail of that normal distribution curve at five or six percent that and your market US Canada versus the rest of the world.
Yeah, we're about 40% US and Canada and 60% rest of the world.
And but basically every company says that. I don't care talking about Densifona. You're talking all these international companies say the same thing. The US Canada market is about 40%. Which is amazing because only 5% of the planet lives in Canada 95%. So that tells me man what a long-term future growth. And the other thing in my short 63 years, when I was little growing up Catholic in Kansas, you know all these big families. There were seven kids in my family and my buddy Brian Hessie there were 21 kids in his family. And just the most messed up child got ortho. I mean everybody would chip in, grandma would chip in. If your daughter looked like she could eat corn on the cob through a chainlink fence, everyone was chipping in to fix the one. And then you go to the next generation and instead of having seven kids, everybody's down to two. So everybody gets ortho. And then they get ortho again, you know, they get it in grammar school and then they get it again in their 20s and then if they get divorced and go back on the market at 40 or 50, they get it again. So now we've gone from just the most messed up child to now it's routine and it's going to go global.
This AI is so big. How is Align using AI across its product portfolio and what does that actually look like in a clinical setting for a solo practicing orthodontist versus a large group practicing orthodontist?
Well, first of all, the algorithms we use to move teeth because of machine learning really are generated in an AI kind of a platform. But as you look forward, I say but when you look forward in the future, we'll take the 23 or 24 million cases we have and we'll be able to come up with a treatment plan and then through AI look at these concurrent cases that occurred all around the world that had a similar malocclusion and say this might be a better way or a way to improve that type of history is what we suggest. And so in the end, it'll be in the doctor's hands in the sense of what they want to do. We'll be able to supply much more data because of the experience and database we have, and you can't do that without AI algorithms. Now look, I'm a CEO, almost like a paid today to talk about AI because all analysts want to know what that is, but we are a database company, whether in manufacturing with 3D printing or how we move teeth with aligners and different things. So AI naturally fits from a technology standpoint within our business and our setup.
Wow. That AI is so, you guys have done 23 million cases. What a database. I can remember one of the neatest things on OrthoTown was someone posted this pano of a really difficult case and I looked at that and I just thought wow, I mean I don't post it's only for orthodontist but if you own the site you can actually spy on and it wasn't even 10 minutes and some orthodontist in Australia posted the exact same case but before and after that he did 10 years ago. Unbelievable. And I thought that was the first sign that the internet is going to change the world. Here's an orthodontist with a dental degree and an MS in ortho and he's asking for help and here's some guy in another hemisphere on the southern pole was a, and it was identical. I mean the pan it was just identical and I thought this internet is going to change the world. And that was before I even knew anything about AI or machine learning. I just knew that kind of like you bought it to open the front door to scanning and all that stuff. The internet was really the front door.
It's true. I hadn't thought about it that way. It's exactly the front door.
Yeah. No internet, no AI. Yeah, that's.
Where does 3D printing and direct fabrication fit into Align's long-term vision? And how close are we to making that clinical reality at scale?
Okay, let's first ground ourselves what we do today, right? We are the biggest 3D printing company in the world but we 3D print molds. So we scan your teeth and we develop a mold for top and bottom of each progression of that till the end, right? But we vacuum form smart track that we talked about over top of it, laser cut it, scallop it to make, and what's wrong with that is you can't vary wall thickness or you can't take advantage of changing the modulus of the plastic. How do you change the modulus of plastic? By making it thicker or thinner in some way to take advantage of that case from a three-dimensional standpoint. You might want to put 40 ms on a molar. If you're going to extrude a tooth, you might want to extrude it with 40 ms instead of 10 ms because you're going to get more displacement on that tooth in some way. You probably want a more interstitial plastic in order to avoid a lot of the attachments that we have today or even IPR that you put on teeth. So, and then 95% of the plastic that we use is recycled or thrown away because you only save that last 5% of that vacuum form over top of it. So, switch over to 3D printing. You would directly 3D print that aligner, right? With the flexibility to be able to do if you want a button on that for a class three, we could have but you want bite ramps in some way. Do you want this thing to be a straight cut or a scallop cut? Do you how do you want and where do you want the thickness of the material to drive whatever particular case that you have from a diagnostic standpoint? You have that power to do that in a direct 3D printed piece. Why hasn't it been done for 30 years is your probably next question. Since I came from a polymer science background, I actually grew up in Pittsburgh in a blue-collar town and we're very similar in a sense of Catholic school or whatever. I grew up in the steel industry and you saw what happened with steel and how it moved in different areas, and that's why polymer science always attracted me. But you go back to polymer science pieces, you could never find a 3D printed polymer because the chains are too short to give you the mechanical integrity to actually move teeth. And that's why we built a mold, that mold is very brittle and we vacuum form over top of it. We had to come up with a long-chain molecule that you could use photo curing with in order to make a direct 3D printed aligner. And that took us six years, hundreds of millions of dollars to come up with a polymer, but you also need a new process to do that. When you do a mold today, you fire a laser into a liquid bath of polymer to cure that polymer to make that mold. In this case, we can't have a viscosity that's that low. We have a real high viscosity. If I showed you the viscosity now, you make a mold out of them and turn it over, it's like water. If I had the new material we have and I turned it over, it wouldn't fall out of the tube. It's that viscous. So you have to have a machine that can 3D print that can actually process that high viscosity material. University of Indiana, we worked with them for years. They had a business called Cubicure. They had a spin-off to be able to process high molecular weight polymers like this for other kinds of applications. We worked with them and then we bought this company called Cubicure because they have the printers to be able to do this. And so we have the polymer, kind of cool. It's naturally derived and we have the process. Now we have to scale it so we can make a million of these a day. When we closed out the first quarter of this year we were printing 1.25 million aligners a day. So you have to scale this to a point that's phenomenal. And we're in that process of scaling now. So you need a new polymer and new process in order to do it. It took a lot of money and time to get there, but it's a breakthrough.
Science. And then we have other things like pre-formed attachments or 3D printed attachments that automatically marry to your teeth to really cut down on the time it takes to put attachments on, but also the exactness of what you do. So there's just different levels of technology we can use also to help to expand productivity and case load in orthodontics. You know, you talked about how in a 10-year period, it went from 5% to 95% to flipped all the way over. So, how long do you think it'll be before a patient walks into an orthodontic office, they get their pano, their staff, AI, the diagnosis, the treatment plan, they decide they're going to do Invisalign, and the dentist prints a tray right there. Say you say it's a tray a month for two years and now it seems like the market's going to two trays a month for one year, better faster easier. How long do you think it'll be before it'll just be a one-stop shop and just like a specialized manufacturing plant printing shop?
All in one. How far are we from that? And
I don't think you'll ever have the economies to really want to do a complete comprehensive case from an office. It's just too many aligners and it's just a piece of equipment.
From the praying part of it.
So, so, so, so the X-ray, the diag...
The diag, but actually the mass scale printing of the trays down to a single orthodontist doesn't look... It doesn't, you know, even I just think it's way too much floor space and time for an orthodontist and polymer. The people you really need experts to know how to run these machines and make it work. It's not the way 3D printing is today. It's not as simple as just firing a mold could do today. It's a much more sophisticated process to do that. So I've always been, not because of my business, and I know several doctors out there will try to make their own aligners or do those kinds of things. It's just most doctors realize over time that it's arduous, you know, machine breaks down, right? It gets clogged up. You have to fix it in some way. Then you have to go outside and order it. It's just I think you have an office that you can't think of like doing a cap milling a cap and crown in an office in some way. There's a huge amount of sophistication of both the plastic and the process to do this. It's better done remotely than it is in an office.
And do you ever see your polymer trays being 3D printed? Do you think...
That's it? That's what we're doing.
Yeah.
But I thought you were like making a sheet sucking down.
We're gonna. That's what we're doing now. That's the 3D that I'm to clarify. No, this is just we just gotten to the point that we can do that over the last year and a half. So I'm only a year and a half behind. Okay, I'll give that.
Yeah, but we now we're not we haven't marketed those yet. We're still trying to go, you know, we have the polymer, we have the process, and now we're working the scale piece to be able to bring that up to a point that we can.
So, you know, usually 3D printing is the opposite of milling.
Would you say your technique now is milling? I mean, you're taking something and trimming it down versus...
Yeah, you know, I used to have a milling business. I had a robotics business one time in my life. And so that's a subtractive industry, right? So you're milling things down like you're talking about it and could talk about machinist all day. I used to work in steel mills when I was growing up, right? And the machinists were the most fun people in the world. They could think in 3D or whatever. But this is different. It isn't subtraction like you talked about. This is addition. In this case, what we do today with the vacuum forming, you actually are making that mold. It's a representation of exactly what you want to make. So you haven't subtracted anything. You've made that mold and then you vacuum form the plastic over top of it to perform as plastic to make it work. So it truly is additive in a way, but true additive is what we're moving toward now, which is you print out a liner fast up without a mold.
So, when they, so you're saying they won't make the polymer tray, but do you think they'll 3D print the models? Because one thing...
We 3D print the models today.
No, I'm talking about in the orthodontist office. Yeah. Well, they do that today some.
But I mean when you go into North's office, if they don't print models, by the time they've been doing it 30, 40 years, they have a second house of just models and then when you need those models half the time they can't even find those.
Oh, so those models I understand. Yeah. Great. We don't print those kind of models. We're just printing the functional models.
Do you think the orthodontist of the future will say I'm not going to have three storage sheds filled with models when I'm retired? I'm just gonna print it and then throw it away and then if I need or give them to the patient with your name and marketing piece, whatever.
If the patient wants it. Right.
And then if you need the models again, you just print them out again.
You print them out. Exactly. It's just the evolution you've gone through in your business is very...
How many? What percent of the orthodontists are doing that today?
I don't know. Significant part are but I couldn't give you exact percent.
Yeah. Interesting. How does Invisalign fit into a broader ortho restorative workflow? And what does Align do to help orthodontists feel confident integrating it into everyday practice?
Well, I think from an orthodontic standpoint, we do our best to make them comfortable with our digital setups with ClinCheck and how you work through those to give them confidence in the sense of the cases they have. And as much as possible, we have a lot of training facilities and work that we do back and forth to really help orthos become confident with using ClinCheck and how to develop this piece. With general dentists, it's a different story. Orthodontists know how to move teeth. With dentists, we have to really help to train them in the sense of how to use these protocols and what they're for. So it's really two different vectors depending on when you talk about ortho restorative and restorative types of procedures. You know, we bought Exocad, which is the world's biggest CAD CAM business for dentistry in the world. We bought that in 2020, 2021.
Out of Germany. Yeah. Very good group. And the reason we purchased them is because we want to do exactly what you said. We want to do ortho restorative. So let's pretend that you were going to do a social six and where you'd normally grind down a lot of teeth and then put caps on and you're going to probably diminish the longevity of the teeth by doing that. What we've come up with a program called ART. It's a Align Restorative Treatment Planning. You'd use aligners for about anywhere for two months or so to spread those teeth apart and to move them so that you could just place veneers on them and avoid having to grind the teeth down. The other part is if you're going to do an implant, often there's a space closure where you have to mill the teeth or cut the teeth down around that. Use aligners for three or four weeks, move that apart, and then you can put that in without having to. So that's the ortho restorative piece that we've been working on and we launched ART last year in Europe. We've moved it to the United States. So it ends up where it's not an aesthetic application like we've really grown up with, but it's more of a functional kind of restorative procedure. We're trying to preserve a patient's dentition for life and help doctors to work with their patients in that manner.
Is your AI going to help? When I got out of school in '87 in the 80s, every orthodontist was routinely doing a lot of four bicuspid extraction and then the market shifted. It was overkill. They didn't need that much space. But I'm still always seeing where the diagnostic said, 'Look, this guy's got five MOD bulk fillings.' And you just redid those fillings in composite. They'd be prettier and you could make them smaller. You might be able to pick up four or five millimeters of space just by redoing these loaded PFMs and fillings. Does the AI help the orthodontist say, 'Man, we could get a lot of space if we replace these four MOD fillings and these two PFMs.'
