Align Technology Inc Q2 2026 Earnings Call

Greetings. Welcome to the Align second quarter 2026 earnings call. At this time, all participants are in listen only mode. A question and answer session will follow the formal presentation. Please note this conference is being recorded. I will now turn the conference over to your host, Shirley Stacy, with Align Technology. You may begin. Good afternoon.

Thank you for joining us. I'm Shirley Stacy, Vice President of Corporate Communications and Investor Relations. Joining me for today's call is Joe Hogan, President and CEO, and John Morici, CFO. We issued second quarter 2026 financial results today via Business Wire, which is available on our website at investor.aligntech.com. Today's conference call is being audio webcast and will be archived on our website for approximately one month. As a reminder, the information provided and discussed today will include forward-looking statements, including statements about Align's future events, product outlook, and financial expectations. These forward-looking statements are only predictions and involve risks and uncertainties that are described in more detail in our most recent periodic reports filed with the Securities and Exchange Commission, available on our website and at sec.gov. Actual results may vary significantly, and Align expressly assumes no obligation to update any forward-looking statement.

We have posted historical financial statements with corresponding reconciliations, including our GAAP to non-GAAP reconciliation, if applicable, and our second quarter 2026 conference call slides on our website under quarterly results. Please refer to these files for more detailed information. With that, I'll turn the call over to Align Technology's President and CEO, Joe Hogan. Joe? Thanks, Shirley. Good afternoon.

Thank you for joining us today. On today's call, I'll start with an overview of our second quarter 2026 results, discuss performance across our two operating segments, clear aligners and systems and services. John will then walk you through our financial results and outlook for Q3 and 2026. After that, I'll come back, highlight a few key takeaways before we open the call for questions. We delivered a solid second quarter with record revenues of $1.06 billion, up 4.3% year-over-year, driven by record clear aligner volumes of 692,000 cases and 8.2% clear aligner revenue growth. Q2 2026 revenues and clear aligner volumes were in line with our outlook, while clear aligner ASPs and non-GAAP operating margin of 22.9% exceeded our expectations.

Q2 2026 year-over-year clear aligner volume growth of 7.4% was driven by continued double-digit expansion across APAC, EMEA, and Latin America, together with stable performance in North America. Growth reflected continuing adoption across orthodontist and GP dentist channels and across adult, teen, and growing patient segments, as well as continued double-digit growth from our DSOs. Investments in patient financing, clinical support programs, doctor subscription offerings, and practice productivity solutions supported adoption and utilization across our global Invisalign business. In systems and services, Q2 2026 revenue performance reflected persistent softness in the capital equipment market, as well as a shift toward lower-priced scanners and flexible acquisition models, including leasing and rental programs, which generate lower upfront revenue than traditional scanner purchases. Overall second quarter results reflect continued execution against a volatile macroeconomic backdrop.

While the environment created some noise in the quarter, the underlying momentum in business driven by ongoing investments in innovation, customer engagement, and digital workflows continues to support improvements in practice productivity, patient conversion, and treatment adoption. For imaging systems and CAD/CAM systems and services, including iTero, exocad, and Align X-Ray Insight software, Q2 revenue of $185.3 million was down 11% year over year as a result of lower scanner ASPs, partially offset by double-digit growth in unit placements driven by continued challenges in the capital equipment market with higher interest rates and increased macro uncertainty.

We continue to lower the total acquisition cost of and expand access to intraoral scanning by offering doctors a range of purchasing options for our iTero Lumina scanner that best fits the needs, budgets, and cash flows of our customers, including low-cost configurations such as iTero Lumina PC and certified pre-owned scanners and rental and lease programs. Importantly, while growing adoption of these purchasing options creates a near-term headwind to reported revenue and profitability, this is an intentionally and strategically attractive evolution of the business. By lowering the upfront cost of adoption, we can expand access to care, grow recurring revenue, and strengthen the Align Digital Platform. We are already seeing the benefits of this strategy. During Q2, scanner placements to new doctors reached a record level and increased double digits year over year, driven by continued adoption of iTero Lumina.

Active scanner units also grew double digits year over year, while more than 12.4 million restorative wellness and orthodontic scans were performed during the quarter, an increase of 16% year over year. Healthy scanner placements, growth in active units, and increasing digital workflow utilization support communications between doctors and patients to improve patient oral health and aesthetics and strengthen the connection between diagnostics, treatment planning, restorative workflows, orthodontic treatments, including clear aligner adoption. Our exocad CAD/CAM business delivered double-digit year-over-year revenue growth in Q2, reinforcing our strategy to expand access to care by seamlessly integrating orthodontics and restorative dentistry across the Align Digital Platform. During the quarter, exocad hosted its flagship Insights 2026 event, bringing together more than 850 dental professionals from over 44 countries.

Launched exocad ART, which means advanced restorative treatment, which combines tooth alignment and restorative treatments within the exocad software to offer more doctors and patients more comprehensive treatment options. Q2 2026 clear aligner shipments reached a record 692,000 cases, increasing 7.4% year-over-year. Growth was broad-based across customer channels, patient segments, and geographies, reflecting continued adoption of the Invisalign system and benefits of our strategic initiatives to improve affordability, patient conversion, clinical confidence, and practice productivity. Growth was supported by both increased doctor adoption and higher utilization. During the quarter, a record 89.2 thousand doctors submitted Invisalign cases, up globally 3.4% year-over-year, while doctor utilization increased 3.8%, reflecting growth across all regions. Shipments to orthodontists increased 7.8% year-over-year, and shipments to GP dentists increased 6.6%, demonstrating ongoing momentum across both customer channels.

Regionally, growth was led by our international markets, EMEA and APAC both delivered double-digit volume growth, driven by increased utilization across doctor channels and patient segments. While Latin America delivered record second-quarter shipments supported by increased submitters and higher utilization. North America remained relatively stable overall, with continued strength in orthodontic and DSO channels helping to offset slower retail demand. Our growth initiatives continue to gain traction across orthodontists, GP dentists, and DSO investments in financing, clinical support, workflow solutions, and practice productivity tools are helping doctors increase utilization, improve patient conversion, and expand access to treatment. Adoption of programs such as DSP, patient financing solutions, and Comp Zero AA, which are designed to support practice growth while improving affordability and access to patients, remain encouraging.

For teen and growing patient, treatment starts increased 7.2% year-over-year, to 240,000 Invisalign cases led by China, Japan, Turkey, India, and Brazil. Continued adoption of Invisalign First, the Invisalign Palatal Expander, and Invisalign MOAB, mandibular advancement with occlusal blocks, reflects greater doctor confidence in our growing patient portfolio and reinforces the significant long-term opportunity we see in these categories. We recently introduced two new capabilities across the Align Digital Platform designed to improve patient engagement, treatment planning, and workflow efficiency. Together with the Invisalign Palatal Expander platform, integrated buttons, custom trim lines, and specific 3D printed attachments, these capabilities strengthen the connection between imaging, diagnostics, treatment planning, and treatment delivery through a more integrated digital workflow.

We featured these innovations this past weekend at the 2026 Invisalign Ortho Summit, our premier peer-to-peer clinical education event, where we brought together our innovations to life demonstrating how we leverage software, visualization, digital treatment planning, and 3D printing, and workflow connectivity to explain clinical applicability, enhance practice productivity, and strengthen customer engagement. Before turning to John, I'd like to briefly address the strategic initiatives press release we issued today regarding Elliott Management. As we've discussed over the past several quarters, we remain focused on strengthening execution, expanding profitability, advancing innovation, and positioning Align to capitalize on the significant long-term opportunity we see in digital orthodontics and restorative dentistry. The initiatives announced today follow constructive discussions with Elliott, are consistent with our objectives, and build on work underway across the company.

First, as part of our ongoing approach to board refreshment and governance, we intend to add three new independent directors whose backgrounds will further strengthen the board's expertise in areas including healthcare technology, innovations, operations, and scaling global businesses. We regularly evaluate these skills and experiences represented on the board to ensure that they align with the evolving needs of our business, and these planned additions reflect that ongoing process. Second, we have initiated a comprehensive strategic and operating model review supported by a leading global consulting firm to help us further enhance commercial execution, organizational effectiveness, scalability, and optimizing resources as we enter our next phase of growth. Importantly, this work is focused on ensuring that we are positioned to capture the significant opportunities ahead while continuing to improve profitability and long-term value creation.

Third, we increased our 2026 share repurchase commitment, reflecting both the board's and management's confidence in Align's long-term strategy, competitive position, and future cash-generating potential. Finally, we appreciate our discussions with Elliott and look forward to continuing a productive dialogue as we execute the initiatives outlined in this separate press release. The board management team remain fully aligned around our strategy, our growth opportunities, and our commitment to creating long-term value for shareholders. Our strategy remains focused on digital orthodontics and restorative dentistry. We're excited for the opportunity to sharpen execution, improve operating leverage, and enhance governance as we continue to pursue the significant growth opportunities. With that, I'll now turn it over to John.

Thanks, Joe. Now for more details on our Q2 results. Total revenues for the second quarter were $1,056.2 million, up 4.3% from the corresponding quarter a year ago, in line with our Q2 expectations. On a constant currency basis, Q2 revenues were favorably impacted by approximately $12.5 million year-over-year, or approximately 1.2%. Q2 clear aligner revenues were $870.9 million, up 8.2% year-over-year, primarily due to higher volume price increases, lower net deferrals, and favorable foreign exchange, partially offset by mix shift to lower price countries and products, and higher discounts. Favorable foreign exchange impacted Q2 clear aligner revenues by approximately $10.6 million, or approximately 1.2% year-over-year.

Q2 clear aligner average per-case shipment price of $1,260 increased 0.8%, or $10 per case on a year-over-year basis, primarily due to price increases, lower net deferrals, favorable foreign exchange, partially offset by mix shift to lower price countries and products, and higher discounts. Q2 systems and services revenues of $185.3 million were down 10.8% year-over-year. As Joe discussed, reported revenue was meaningfully affected by the ongoing and strategic evolution of our scanner business model, including greater adoption of lower-cost system configurations and a growing mix of leases and rentals relative to upfront purchases. These options lower the initial cost for customers and are helping us expand patient access to digital diagnostic, restorative, and orthodontic treatment through iTero scanners, Invisalign clear aligners, and the Align Digital Platform.

During the quarter, placements to new doctors reached a record level and increased double digits year-over-year, while our active scanner install base grew approximately 11% year-over-year. The growing adoption of lower priced scanner configurations, including leasing and rental programs, reflects our commitment to expanding customer choice and increasing access to digital dental workflows. By offering a broader range of acquisition options, we are enabling more practices to participate in digital orthodontic and restorative care. This is intentional. As the install base grows, we create opportunities to expand the funnel for orthodontic and restorative treatment, which is better for patients and doctors and carries higher margin and recurring revenue. We are giving up certain economics at the point of sale to expand patient access to treatment, giving doctors the tools they need to provide the treatment and increase volumes and revenues on the back end.

Q2 systems and services revenues reflected lower system ASPs, driven in part by increased adoption of lower-cost configurations and lower scanner wand sales, partially offset by higher systems volume, higher non-system sales, and favorable foreign exchange. Foreign exchange favorably impacted Q2 systems and services revenues by approximately $1.9 million year-over-year, or approximately 1%. Moving on to gross margin. Second quarter overall gross margin was 71.7%, up 1.8 points year-over-year, primarily due to operational efficiencies, tariff refund, and higher clear aligner ASPs. Q2 overall gross margin was unfavorably impacted by foreign exchange of 0.8 points year-over-year. On a non-GAAP basis, which excludes stock-based compensation, amortization of intangibles related to certain acquisitions, depreciation expense on assets disposed of other than by sale, restructuring, and other non-GAAP charges, gross margin for the second quarter was 72.3%, up 1.8 points year-over-year, or up approximately 2.6 points at constant currency.

Clear aligner gross margin for the second quarter was 71.4%, up 1.3 points year-over-year, primarily due to higher ASPs and operational efficiencies, partially offset by higher freight costs. Q2 clear aligner gross margin was impacted by unfavorable foreign exchange of approximately 0.8 points year-over-year. Margin expansion is increasingly driven by lower refinement rates, improved treatment predictability, and higher manufacturing throughput, the result of Align's intentional investment in a data, software, and manufacturing-driven flywheel that compounds with scale. Many of our lower priced product configurations, such as Comp 3 and 3 and DSP Touch-up, include fewer or no additional aligners and require less manufacturing costs, supporting gross margins and improving cash conversion despite lower upfront pricing. The clinical versatility of the Invisalign system allows us to offer configurations such as Zero AA products, enabling doctors to expand Invisalign adoption while meeting patient expectations.

These offerings enhance our ability to compete against traditional wires and brackets and lower priced clear aligner alternatives while allowing us to address a broader range of case complexity and price points without compromising long-term unit economics. Systems and services gross margin for the second quarter was 73.3%, up 3.9 points year-over-year, primarily due to operational efficiencies and tariff refund, partially offset by lower ASPs. On a year-over-year basis, Q2 systems and services gross margin was unfavorably impacted from foreign exchange by approximately 0.6 points year-over-year. Q2 operating expenses were $603.4 million, up 10.7% year-over-year. Year-over-year operating expenses increased by $58.3 million, primarily due to U.K. VAT accrual and higher employee compensation. On a non-GAAP basis, excluding stock-based compensation, legal settlements and contingencies, restructuring, and other charges and amortization of acquired intangibles related to certain acquisitions. Q2 2026 non-GAAP operating expenses were $521.5 million, up 4.8% year-over-year.

Our second quarter operating income of $154 million resulted in an operating margin of 14.6%, down approximately 1.5 points year-over-year. Operating margin was unfavorably impacted from foreign exchange by approximately 1.4 points year-over-year. On a non-GAAP basis, which excludes stock-based compensation, legal settlements and contingencies, restructuring and other charges, and amortization of acquired intangibles related to certain acquisitions, operating margin for the second quarter was 22.9%, up 1.6 points year-over-year, or approximately 3.1 points at constant currency. The Q2 2026 GAAP effective tax rate was 27.2%, compared to 28.2% in the second quarter of 2025. The second quarter GAAP effective tax rate was lower than the second quarter effective tax rate of the prior year, primarily due to increased earnings in low tax jurisdictions. Our Q2 2026 non-GAAP effective tax rate was 20%, which reflects our long-term projected tax rate.

Second quarter net income per diluted share was $1.51, down $0.20 compared to the prior year. On a non-GAAP basis, net income per diluted share was $2.64 for the second quarter, up 6% year-over-year. Our GAAP and non-GAAP EPS was unfavorably impacted by $0.23 on a year-over-year basis due to foreign exchange. We continue to maintain a strong balance sheet and healthy free cash flow, providing flexibility to invest in innovation, support customers, and return capital to shareholders. As of June 30th, 2026, cash and cash equivalents were $1,102.6 million, up $201.4 million year-over-year. Of the $1,102.6 million balance, $241.1 million was held in the U.S., and $861.5 million was held by our international entities. Align maintains a disciplined capital return program.

During Q2 2026, we repurchased approximately 393.4 thousand shares of our common stock at an average price of $169.45 per share for a total of $67 million. These purchases were made pursuant to the $200 million open market repurchase plan announced on April 29th, 2026, which we expect to be completed in October of 2026. In connection with the expanded value creation initiatives announced today, we now intend to repurchase an aggregate of approximately $400 million-$500 million of our common stock during full year 2026, inclusive of the repurchases under the $200 million plan. As of June 30th, 2026, $733.3 million remains available for repurchase of our common stock under our $1 billion stock repurchase program announced in April of 2025. Q2 accounts receivable balance was $1,148.4 million. Our overall days sales outstanding was 98, down one day as compared to Q2 of 2025.

Cash flow from operations for the second quarter was $192.8 million. Capital expenditures for the second quarter were $35.7 million, primarily related to investments in our manufacturing capacity and facilities. Free cash flow, defined as cash flow from operations minus capital expenditures, amounted to $157.1 million. We continue to maintain a strong balance sheet and generate healthy cash flow, providing flexibility to invest in innovation, support customers, and return value to shareholders. We remain focused on disciplined capital allocation and long-term value creation. In summary, our second quarter results reflect continued execution across the business. Solid clear aligner performance, disciplined expense management, and operational improvements supported revenue growth in line with our outlook and non-GAAP operating margin above our expectations. Our growth initiatives continue to drive doctor adoption, utilization, and patient conversion.

While Q2 2026 systems and services revenue was below our original expectations, underlying scanner adoption remained healthy, and the reported lower revenues reflects lower-priced scanners and the transition toward lease and rental models that increase patient access to care by offering a broader range of purchasing options and increasing adoption of our digital scanning technology. This is a deliberate trade-off on our part. While this model may impact upfront economics and timing of revenue recognition, it enables us to serve more customers and to drive for higher margin treatment revenue and durable long-term growth. Stronger clear aligner revenue growth and ASP performance helped offset the near-term impact. Before I turn to our outlook, I want to provide an update on the U.K. VAT situation. Following the First-tier Tribunal's 2025 decision that clear aligners qualify as VAT-exempt dental prosthesis, we stopped charging VAT to U.K. customers effective August 1, 2025.

On July 7, 2026, the U.K. Upper Tribunal overturned that decision, determining that clear aligners do not qualify as VAT-exempt dental prosthesis. We acknowledge the ruling and will comply with applicable law. Effective September 7, 2026, invoices will include U.K. VAT at 20% on applicable Invisalign aligners and Vivera retainers. Our list price remain unchanged. As a result of the ruling, we have recorded an estimated liability of approximately $37.5 million, inclusive of interest. We intend to appeal, though the ultimate resolution remains subject to uncertainty. Turning to Q3 and fiscal 2026 business outlook.

Assuming no circumstances occur beyond our control, such as foreign exchange, macroeconomic condition, and extended war, and changes to currently applicable duties, including tariffs or other fees that could impact our business. We expect Q3 2026 worldwide revenues to be in the range of $1 billion-$1.02 billion, down sequentially from Q2 2026. We expect Q3 2026 clear aligner volume to be up mid-single digits year-over-year, and Q3 2026 clear aligner ASPs to be down sequentially from geographic mix and foreign exchange. We expect Q3 2026 systems and services revenue to be down sequentially and year-over-year because of Q3 seasonality, alongside a continued mix shift towards lower-priced scanners and flexible acquisition models, including leasing and rental units and certified pre-owned offerings.

We expect Q3 2026 worldwide GAAP gross margin to be 67.5%-68.5%, down sequentially approximately by three to four points due to the incurrence of one-time charges expected to be approximately $20 million-$30 million, primarily for accelerated depreciation and restructuring and other charges in Q3 2026. We expect Q3 non-GAAP gross margin to be approximately 71%, down sequentially from lower ASPs consistent with typical Q3 quarter-over-quarter trends. We expect Q3 2026 GAAP operating margin to be between 13.5% and 15% due to the incurrence of one-time charges expected to be approximately $35 million-$50 million, primarily for restructuring and other charges and accelerated depreciation in Q3 2026. We expect Q3 2026 non-GAAP operating margin to be approximately 24%. For fiscal 2026, we continue to expect 2026 worldwide revenue growth to be up 3%-4% year-over-year.

Our full year 2026 revenue guidance continues to assume a benefit from foreign exchange that is consistent with the assumptions underlying our initial full-year outlook. We expect the effect of foreign exchange to moderate in the remaining quarters, trending towards the full year assumption of approximately 100 basis points. We now expect 2026 clear aligner volume growth to be up approximately 6% year-over-year, and 2026 clear aligner ASP to be flat to slightly down from 2025. We now expect 2026 systems and services revenue growth to be down 6%-8% year-over-year, as we anticipate a continued mix shift towards lower-priced scanners and more flexible acquisition models in the second half of 2026. We expect our 2026 iTero scanner shipments to be up double digits year-over-year, reflecting continued customer adoption and scanner placements and helping to underpin our second half outlook for Invisalign volumes.

We expect 2026 GAAP gross margin to be approximately 70.2%-70.5%, up year-over-year by approximately three points due to the incurrence of one-time charges expected to be approximately $30 million-$40 million, primarily for accelerated depreciation, restructuring, and other charges, partially offset by a gain on assets held for sale. We expect 2026 non-GAAP gross margin to be up approximately 100 basis points over 2025 non-GAAP gross margin. We expect 2026 GAAP operating margin to be approximately 15.1%-15.6%, up year-over-year by approximately two points due to the incurrence of one-time charges expected to be approximately $90 million-$100 million, primarily related to restructuring and other charges, accelerated depreciation, legal settlements, partially offset by gain on assets held for sale. In Q2 2026, we recorded $38 million for clear aligner U.K. VAT liability. We expect 2026 non-GAAP operating margin to be approximately 23%, a 100 basis point improvement year-over-year consistent with our previous guidance.

We expect our investments in capital expenditures for fiscal 2026 to be $125 million-$150 million. Capital expenditures primarily relate to technology upgrades, additional manufacturing capacity, as well as maintenance. We now expect to repurchase $400 million-$500 million of our common stock in 2026, reflecting the conviction of the board and management in Align's long-term value. This includes the approximately $133 million of our common stock we expect to repurchase through October 2026. Before I hand it back to Joe, I want to take a moment to offer some preliminary high-level framing for 2027, especially given the work we are doing to drive growth, cost discipline, and margin expansion. To be clear, we are not issuing formal guidance for next year.

It's too early and our strategic and operating model review is still underway. However, we remain laser focused on executing our strategic plan for profitable revenue growth across our two operating segments. Based on our continued progress and the initiatives we outlined in the strategic initiative press release today, we are comfortable targeting at least the same level of improvement in operating margin in fiscal 2027, on top of the approximately 100 basis points of operating margin improvement we reiterated for fiscal 2026. For fiscal 2027, we currently expect GAAP and non-GAAP operating margin to increase at least approximately 100 basis points year-over-year. We'll share more details after our strategic and operating model review is complete, and in conjunction with formal 2027 guidance. With that, I'll turn it back over to Joe for closing comments. Joe? Thanks, John. As we look at the first half of 2026, we're encouraged by the progress across the business.

Through the first six months of the year, we delivered record clear aligner volumes, expanded doctor adoption and utilization, increased scanner placements, improved margins, and continued to execute against our strategic priorities. Importantly, we achieved these results in an environment that remains uneven across markets and customer segments, reinforcing the strength of our global business. We saw strong momentum across APAC, EMEA, and Latin America, despite the macroeconomic headwinds. North America remained relatively stable overall, with continued strength in the DSO channel, helping to offset softer retail demand. That said, returning North America Retail to consistent growth remains a top priority, and we're working to make that happen.

The customer-focused initiatives we've been pursuing, financing solutions, DSP, clinical education and support, and DSO collaboration, are gaining traction, and we're encouraged by the early results. As we enter the second half of 2026, we believe we are well-positioned to build on this momentum. We are entering the important teen treatment season with one of the industry's most comprehensive digital treatment portfolios for growing patients and teens. At the same time, we continue to expand opportunities in adult treatment through innovations that connect oral health, restorative workflows, and digital orthodontics, helping doctors incorporate Invisalign treatment into broader patient care discussion. Our innovation engine remains a key differentiator and is central to our growth strategy. Business model innovation, patient financing, subscription programs such as DSP, no AA offerings, and digital workflow innovation are helping doctors improve patient conversion, increase utilization, and grow their practices.

Every digital workflow begins with a scan, making scanner adoption an important driver to increasing patient access to orthodontic care and long-term platform growth. As we continue to advance our innovation roadmap and direct fabrication technologies, we are creating more effective and personalized treatment solutions that improve clinical outcomes, enhance operating efficiency, and strengthen the customer experience across orthodontics and restorative dentistry. Our focus remains unchanged: helping doctors treat more patients, expanding patient access to care, and advancing digital orthodontics and digital dentistry globally. We remain realistic about the environment, but encouraged by our results and ability to address the significant opportunities ahead. Importantly, the combination of our global scale, strong international momentum, continued innovation, and an increasing integrated digital platform uniquely positions Align to drive adoption of the Invisalign clear aligner and iTero systems and services while creating long-term value for customers, partners, employees, and shareholders.

With that, I want to thank you for your time today. I'll turn the call back over to the operator for questions. Operator? Thank you. At this time, we'll be conducting a question and answer session.

If you would like to ask a question, please press star one one on your telephone keypad. A confirmation tone will indicate your line is in the queue. You may press star one one again if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star key. One moment please while we pull for questions. Our first question comes from Michael Cherny with Leerink Partners. Your line is open. Good evening, thanks for taking the question.

Maybe if I can just ask a question about the case starts number. Obviously very strong in the quarter, seemingly talking up your expectation for the rest of the year. As you think about the push and pull of macro/micro and what you're seeing in your different customer bases, what's the biggest level of confidence that's allowing you to get to this higher number, given obvious questions broadly in the market about whether or not the consumer is at risk? Seems like really good numbers, just trying to put the pieces together about how do you keep the momentum going. Thank you. Hey, Michael. When I look at it, we felt really good, obviously, about the Invisalign numbers overall, that's your inquiry.

As we talked about, we have a good mix around the world. It's a strong global business. We see APAC at double-digit growth. We're seeing double-digit growth that we have in Europe and in different sections and areas. Our DSO businesses are very strong in North America overall. With that kind of a mix, it gives me a lot of confidence in the sense that with macroeconomic headwinds and different things, that we can help to compensate that because it's never the same all over the world. I think the quarter reflects pretty well that dexterity we've shown in the marketplace.

Thank you. Our next question comes from Jonathan Block with Stifel. Your line is open. Great.

Thanks, guys. Good afternoon. Hey, Joe. Maybe I'll pick up where you left off a little bit, Joe. Any signs that the North American, call it independent sluggishness, is starting to thaw? I'm excluding the DSOs. What are the green shoots you're looking for? Is there a secret sauce? In other words, can the additional financing options that we're hearing more about, this no comp AA, sort of help turn the tide in coming quarters, again, specific to that North American independent bucket?

Yeah, John, great question. Look, we just got back from the orthodontic conference that I referenced overall, too. There's a lot of enthusiasm by that group. Obviously, there are best doctors in North America overall, and John and I have known these doctors for a long period of time. There's a lot of enthusiasm there, but I don't think anyone's counting on the macro to help us one way or another. What they feel good about is the innovations that we have here, how it can extend. In my script, I talked about the growing patients piece. When you think about mandibular advancement with occlusal blocks, IPE, there's a huge amount of enthusiasm about that and help us from market share, too. Obviously, DSP has been a big winner, and we continue to try to expand that.

The no-AA product that you just referenced is just a good fighter out there in the sense of trying to meet a consumer where they are sometimes. Overall, I just feel good about our portfolio. I feel good about the innovation that we have and how it's being accepted in the marketplace. Our forecasts that we just gave you are not reflective of any kind of improvement in macro. We're not that smart. We just keep executing in those specific areas of new products and new types of systems to drive up volume.

I would add that patient financing, expanding that patient financing, we are seeing some traction there. We want to continue that, but that helps that potential patient decide if they want to go into treatment.

Okay, that's helpful. The second one's a little bit long. John, I'll go to you. Systems and services now expected to be down 7% year-over-year at the midpoint. I think prior, at least I was flattish. That difference of $55 million seems to be made up all clear aligner revenues. Somewhat split between a higher volume assumption and a slightly higher ASP. One, is that a fair way to sort of define that or categorize that? Then maybe you can talk, John, the higher ASP surprised at least me for the quarter. It was a little bit above where you were talking $1,260 versus $1,250. Arguably, FX went against you a bit intra-quarter. What led to that better ASP result that seemingly you feel comfortable about extrapolating going forward?

You're right on your first question. The systems and services being down 7% at the midpoint for the year is being offset by the Invisalign volume and stronger ASPs for what we've talked about, where you see some stability that continues in North America, then growth outside of that to be able to take our volumes up. When we look at the ASPs, we see some of the benefit in terms of some of the products that coming through where you're seeing some of the products maybe at a slightly higher price or higher list price, which helps us. That helps our overall ASPs. We also get some of the benefit where we're recognizing still a significant amount of revenue, even on those Invisalign Comprehensive 3 and 3, which is our most popular product, as well as the no-AA product.

We're seeing that ASP come through, that showed up in our numbers. I would also say that maybe when we look at our ortho business in total, when we look at that, we saw some strength there overall, which usually comes with a higher list price as well. Those are the offsets that we see. We're pleased with the ASPs being able to hold to where we're at, you're right, that does help us as we go into the second half of the year.

Great. Thanks for the time, guys.

Sure. Thanks, John. Thank you.

Our next question comes from Brandon Vazquez with William Blair. Your line is open. Hey, everyone.

Hi, Brandon. Thanks for taking the question.

Hey, guys. Maybe I'll ask two, because it's a little bit of a two-parter connected. One, I want to ask a little more granular on North America. Can you guys just talk about, like, because we don't know the relative trends U.S. versus outside of the U.S. Did things get worse within the quarter within North America? I know there's been a lot of noise, rising gas prices, et cetera. Some channel checks have suggested maybe there were some pockets of weakness. Curious, what are you seeing in the U.S. specifically? The follow-up question then maybe for John, with an updated guidance here for clear aligners, how do you think about what's baked into that? Are you taking the exit rate from Q2 and pushing that forward? Just help us understand. The seasonality in the business has been a little lumpy, of course, over the past couple of years, so it's hard to know what Q2 to Q3 usually is.

How are you guys thinking of framing the guidance relative to macro today? Thank you. Hey, Brandon, it's Joe.

I would just start off by saying stable from a North America standpoint. There is a lot of fluctuation when you look at different regions, if you look at the Northeast versus Florida, California, whatever. I don't want to go into specificity of that. Overall, I would call it stable. The DSOs continue to grow, as I mentioned in my script overall. I would say basically what we've seen is no better and no worse than what we've seen before. Obviously, we just keep working our portfolio, working with the DSOs, all the things where we've been having success to try to extend that.

I would build on that. That stability or those numbers that we see coming out of Out of Q2, when we take guidance, we're looking at the most recent information. We have a good understanding of flow, and that's the best information that we can use for prediction of the next quarter. We take what we see. Like Joe said, it's relatively stable. There's pockets that are better or worse, but that's to be expected. That's what we use to inform us for our guidance.

Thank you. Our next question comes from Jason Bednar with Piper Sandler. Your line is open. Hey, good afternoon.

Thanks for taking the questions. I'll actually start first on the operating model review. I know it's super early. Are there any obvious areas of optimization that you have in mind? Is everything under consideration across your expense line when we think about R&D, sales, marketing? Maybe asked differently, is anything off-limits when we think about your commitment to 100 basis points? Just trying to understand and think about this review in the context of past restructuring activities for Align.

Hey, Jason. Joe. Look, I'll just start off and say our strategy remains intact and our strategy, we're a growth business, we know that. We technology led, distribution led in that sense. I'm not saying anything is completely off of this. We'll look at across the board and see what makes sense, and I think it's a good progress, a process for us. We picked a really good consultant to work through that has some experience with this also. There's a basis for us to work through that. I just look at this as an opportunity. I think when you look at execution, you want to say where your focus is or whatever, I think it's healthy for the business.

Okay, fair enough. Then maybe building on that, I thought for 2027, direct fabrication was supposed to be a margin driver. Is that in addition to this 100 basis points? Is that captured in this 100 basis points? I guess, maybe update us on how you think about direct fabrication within the context of the updated margin commentary today.

Yeah. Jason, think of this as this is inclusive of everything for next year. This is the best view that we wanted to give. As you know, and we've talked about, when direct fabrication scales up, that by itself is a negative headwind, just as you scale that, just the efficiency and everything else that we need to have, both on the resin side as well as the actual production side. The view that we gave next year includes that direct fabrication, the overall 100 basis points or above is inclusive.

Got it. Thank you. Thanks, Jason.

Thank you. Our next question comes from Daniel Grosslight with Citi. Your line is open. Hey, guys.

Thanks for taking the question. Wanted to dig a little bit more into the systems revenue. Obviously, a few moving pieces here. I'm curious, what's been the biggest surprise versus your initial expectations? Is it the rental adoption, lower ASP, macro pressure? Just what's been the biggest change in how you're thinking about that? Maybe more importantly, how should we be thinking about systems revenue in 2027? Will these headwinds be behind us, so we should see a return to growth in 2027? Do you think we'll still see some lingering impacts of mix? Thanks. Hey, Daniel. This is John.

First off, we're not guided on revenue for next year, but I can kind of get to focus on what we've seen so far this year. We certainly do see that mix that we described in the script where you have doctors that are making decisions on whether they're going to purchase new or perhaps a certified pre-owned, or maybe doctors don't want to put so much money up front, and they'll lease or they'll rent. You do see that shift happening across, and that certainly shows up in our numbers. You also see maybe retail doctors that they don't maybe feel as certain, especially in North America, certain about the economy and so on. They pull back on their spend.

We had some favorable mix, at least from a volume standpoint, that showed up with DSOs and some of our labs. You see that coming through in volume. I would take a step back and say, overall, we're pleased with the volume. The volume is double digits. Our installed base is up double digits. We are expanding the availability to doctors to be able to get new scanners and purchase them or utilize them any which way that they want. The added piece that's a benefit that we've seen, and more so that I've seen in the past, is so many of these new scanners that have gone into placement are new doctors that we don't even sell to right now.

We know that as they start to get more familiar with that scanner and digitize their workflows, it helps us for the broader ecosystem that we have, which includes the Invisalign. We feel good about that volume and that placement, and we're managing the mix as we go forward.

Got it. Okay. I also had one on just the U.K. VAT ruling. I think you mentioned that you're not going to change list prices here despite the reimposition of the tax. Does that mean you guys are absorbing the cost here, or just how does that work from a pricing perspective? Does that impact your profitability targets in the U.K.?

Just to be clear on that, we're keeping our list prices the same. Now that the U.K. is mandating this VAT, that's essentially being charged to the provider, the customer, and then we pass that through back to HMRC. It's no impact to us from an ASP standpoint. Of course, we're going to appeal, and of course, we don't think it's good for U.K. dentistry and healthcare and ultimately patients who want to go into treatment. It's a pass-through, and it's something that won't impact our ASPs as a result.

Got it. Thank you. Thank you.

Our next question comes from Jeff Johnson with Baird. Your line is open. Thank you.

Good afternoon, guys. Jeff. Hey, Joe.

I wanted one question on third quarter on case shipment growth and your guidance for that. As I look at the 2Q to 3Q comp, it gets about four and a half points tougher. You just did 7%. You're guiding to mid-single digits for 3Q, so maybe a couple points of slowing, but on a comp-adjusted basis, a little better. I know you keep saying stable. I know in my surveys, I'm sure not seeing much evidence of improvement or anything, but it seems like your guidance is calling for, at least on a comp-adjusted basis, a little bit strengthening on that case shipment side in the third quarter. Is that confidence coming from anything you're seeing in that North American market with some of the new financing options like you're talking about? Is it coming from something you're seeing outside the U.S.?

Just where may be seeing a little bit, as John referenced earlier, I think green shoots on that. Thanks. Yeah, I would say, Jeff, when you look at what we're seeing, we're seeing continued adoption of DSP.

DSP is now rolling out to APAC, which we know it drives volume through those touch-up cases and ultimately gives retainer revenue as well. We're seeing that. We see the continued rollout of the no-AA type products. That's really our fastest-growing segment that we see within our portfolio. As doctors start to use it, they start to learn, kind of almost pay as you go with the refinements that come later. That's been a good adoption that we see. We talked about some of the financing. More and more doctors are using this to be able to help get those reluctant patients to, or potential patients to go into treatment. We're not relying on economies essentially getting better or really changing at all.

It's things that we could do to drive that incremental benefit as we look forward. I would say broadly, as you look at it, Jeff, we were running about 7% volume on a year-over-year basis in the first half. The second half, it's actually a little bit less than what we ran in the first half. We're reflective of what we see in the market, but we feel good about the initiatives that we have.

All right. That's helpful. Thanks, John. Then maybe one more just on the scanner and services. I know the question was just asked. I'm going to try to get at it maybe a slightly different way. I know you're not guiding to 2027 at this point, but are you guys taking a decent amount of medicine up front here? Have you put some of those pricing programs in, whether it's the CPOs or the lease and rental in that pretty aggressively to the point that let's say 10% or 15% of your new user base is going in that direction? Would we think over the next couple of years that stays the same, or is it going to be 10% of your user base is adopting those kind of lower price models this year and next year it might be 15% or 20%, the next year 30%?

We have that kind of continued negative mix head when we should be thinking about, at least conceptually, on your scanner and services side the next couple few years. Thanks. I would look at it this way, Jeff.

I think we're taking this shift, this mix shift that is happening now, and that's really impacting this year. We've called that out. We think we build off of that as we go forward. There's a certain amount of ASP that we have as a result of this, and we build off of that going forward. It's not to say that doctors won't want to continue to lease and rent, but as you go forward with that, as you know, when you start a lease, you might only take one or two or maybe three months of that revenue in that period, but you're going to get that revenue for the next 24, 36 months going forward. We know that piece of it builds.

You're also going to see us do some things around using third-party providers to be able to provide the financing, more of a capital lease structure, such that we can now sell to that capital provider at a higher ASP, then they'll provide the leasing arrangement to those customers. That helps us so that we don't have to take the operating lease on our side. There's alternatives that we have, but ultimately, we want to be able to drive this business and understand the mix that's going on in the world, but be able to be at a point where we can build off of that as we go forward.

Understood. Thank you. Sure. Thanks, Jeff.

Thank you. Our next question comes from Elizabeth Anderson with Evercore ISI. Your line is open. Hi, guys.

Thanks so much for the question.

Of course. As we think about your outperformance on gross margins in the quarter and sort of the updated outlook that you provided, is there something to think about differently between sort of the mix of operating margin expansion in 2026 between gross margin and OpEx, or should we still think about it kind of 50-50 split that you laid out last quarter?

Yeah, I would say, Elizabeth, this is John. Think of the margin expansion that we've seen. We're very pleased with our up margin expansion. It's primarily driven by the gross margin side. We are seeing a lot of the productivity that we've talked about from last year, some of the productivity improvements around getting closer to our customers, reducing our freight costs, upgrading some of the equipment, using things productively, as well as some of the product mix that's really helping us from a gross margin. The no-AA type products, the Three-in-Three, and so on, those give us a better gross margin, DSP, and so on. I would say it's a combination in that productivity where we're doing things to help from a product standpoint that drives gross margin, as well as a program and initiative standpoint to take costs out to reduce our COGS.

So far this year, and the way we're describing this year, it's really been primarily on the gross margin side to generate that 100 basis point improvement in 2026.

Got it. Maybe as a follow-up, obviously, the questions about the macro forefront, and I appreciate what you're saying about sort of the self-generated improvements and the case numbers for the third quarter. Can you give any early commentary sort of on July, particularly regarding the U.S. and sort of how that's trending versus your expectations?

You know how that goes, Elizabeth. We don't give kind of within the quarter, kind of the monthly cadence. I would say as we've done, we factor in how the quarter plays out, previous quarter plays out by geography and so on, look at order and intake, and then make the best view of that, and that's how we'll guide. That's how we've done it for every quarter and including this third quarter.

Appreciate it. Thank you. Thank you.

Our next question comes from Steven Valiquette with Mizuho Securities. Your line is open. Oh, thanks.

Yeah, good afternoon. A lot of topics have already been talked about here. One thing I wanted to come back to was back at the tech innovation meeting that you had with us back in May, you guys highlighted the new Advanced Restorative Treatment program, targeting dental labs to get further traction with GPs. Just curious how much that might be playing a role in the increased guidance for 2026. Does that maybe get more traction for 2027? Just want to get an update on how we think about the progression of that. Thanks. Yeah. Hi, Steve, it's Joe.

Look, it is not a huge increase right now. We see a number of labs across the world that are adopting this. They're beginning to integrate it into their workflow, particularly for implants and crown and bridge and those kinds of things where you move teeth first to keep the teeth out of harm's way and save the enamel in that sense. As you look at our 2027, don't count on us leaning way into that in some way, but I feel good about that. I think we're making good progress. There's a good recognition of it. We've integrated much better into our exocad system. As a lab works with exocad, they can immediately access ClinCheck and different things that would allow them to be able to plan that treatment properly, obviously, with the aligners upfront. I'm optimistic about it. I'm not forecasting a big increase here right now, but we'll keep you up to date as it continues to grow.

Okay. Got it. Thanks. Thank you.

Our next question comes from Vik Chopra with BMO. Your line is open. Hey, good afternoon.

Thanks for taking the questions.

Of course. For systems and scanners, you called out more flexible acquisition models.

I'm just curious how big the proportion of systems placed under lease arrangements or rentals can grow to over time, and how should we think about the economics and payback period of this strategy?

Yeah, it's a good question, Vik. Right now, it's a small percentage of our overall revenue, look, I think especially in certain markets, it's a big percentage in some of those markets. I would expect that as doctors and others are under pressure from a capital equipment standpoint, that they might try to lease or rent. From our standpoint, that's a good equation for us because typically then that price is higher in terms of what they're going to pay us over time. You don't have to discount as much initially to get a sell-through. They're happy to rent or lease. They keep their monthly payments low. In the end, we end up with maybe a higher amount of revenue over time. It doesn't come right up front. Again, we're trying to provide access to our digital ecosystem.

This is a way to do that with our customers, we have the portfolio and the resources to be able to provide that. When we see that the volume that we put into the market this quarter and to see that the install base is going up and, like I said earlier, really pleased with the fact that we're selling to doctors that we haven't sold to before. We know good things happen when that comes about.

Thanks. Just one quick follow-up, if I could. You called out the North American retail channel. I'm just curious if that were to stabilize or return to growth, how much of a benefit is that to your top line? Thank you. Yeah, it would certainly be a benefit because right now it's a drag.

On that retail side, we are laser focused on all the different initiatives we have to turn that. We think we can, even in this current environment. If the economic environment gets better, great. That's a tailwind for us. We think we can turn this to be positive in this existing environment using all the tools that we've talked about here. If it does, it certainly would be an improvement to our overall volume that we've described.

Thank you. Our next question comes from Erin Wright with Morgan Stanley. Your line is open. Great.

Thanks. I want to dig a little bit more into the clear aligner financing initiatives and some of the ones you've launched recently. How do you think about the rollout of that? How have you rolled that out, when do you think it'll really move the needle from a conversion perspective? Do you anticipate or do you have any sort of early metrics on that front? I just had a quick follow-up on the U.K. VAT tax. I think before you lowered the price by 20%, you're saying you're holding the price, does that mean you're anticipating a volume impact at all? I'm just curious how you're thinking about that flowing through. Thanks. Okay, thanks, Aaron. I could talk about the U.K.

VAT initially just on that we will keep the prices the same, that U.K. VAT will get passed on. We are looking at what that could mean for volume and making sure we stay close to our customers and so on. They're aware of that change, and we're working closely with them. Like I said, that VAT is a pass-through, no impact on our ASPs. You're right. We want to make sure we understand the volume and the trade-offs and so on, maybe gives us a good opportunity to talk about the other portfolio of our products that do come at a lower list price so that maybe there can be some offset if they were used to using some of the more comprehensive, unlimited, or other products that they can use other parts of our portfolio.

We'll watch that closely. When we think of the clear aligner financing or financing for potential patients and so on, we're seeing good traction on this. When we have a doctor that provides different financing alternatives to external providers, if those providers are very interested in increasing their amount of revenue that they could get from these types of procedures, we're seeing good traction. That means low upfront costs.

It means making sure that monthly payment is low enough. It's being able to manage maybe some FICO scores and so on. Doing things in a way to make sure that we could drive that ultimate patient to go into treatment. Where we've done that, we've seen good adoption, and that's part of what we want to be able to continue to see as we go forward.

Thank you. Our next question comes from Michael Ryskin with Bank of America. Your line is open. Great.

Thanks for taking the questions. Two really quick ones, probably. One is on the scanner. You touched on sort of some of the awareness and some of the macro CapEx environment impacting docs. There's also been some incremental competition in the space from a handful of others with launches in the last three to six months. Just wondering if you're seeing that play in the market at all, if you're bumping into them a little bit more, if there's been some noise there. I'll throw in my follow-up at the same time. The ASPs, you kind of have guided to softer ASPs in the second half for some time. You tweaked your ASP guide this quarter, but it seems like you're still guiding for a pretty big step down in Q3, Q4 just to get for full year to be flat to down.

It's pretty meaningful at $40, $50 step down. I know you talked about FX and mix, but would be great if you could just dig into that a little bit more, break down those two components and if it is mix, just expand on that a little bit. Thanks. Michael, I can take the ASP question first.

You certainly have, as we know, going from Q2 to Q3, with China being as big as it is and Europe kind of coming a lot lower than what it would normally just based on seasonality. You do have a mix effect that hits ASP, and that's why we reflected the ASP reduction going from Q2 to Q3. You have that. We think that it obviously comes back a bit in the fourth quarter because that mix shift then changes. China's lower as a proportion and Europe becomes larger. We have that. There's nothing out of the ordinary. We're going to continue to have DSP and some other products that get rolled out in the second half in APAC and so on. That comes with a lower list price. It's just the reality. It's products that just don't have as high of a list price because they're non-comprehensive cases.

Mix shift, that's normal in the third quarter. Other new products in certain markets, like DSP, impact the overall ASP. Michael, too, on the scanning side, I'd say I don't see rapidly increased competition. I'd say the composition of the competition has changed pretty substantially over the last few years. We used to see a lot of Medit. We see more Shining 3D than we do Medit today. That's on what I'd call the lower-end mirror-based scanners. When you look at the confocal imaging piece, which is primarily represented by our old technology, which is 5D, and you have that obviously with Primescan and 3Shape having that technology. That hasn't changed in a big way either. Lastly, remember with Lumina 2, that's a brand-new technology.

It's a different kind of platform, it gives us a really good competitive position to be able to work through. Overall, this isn't driven what I'd say by a big change in competition, but we have seen a change in the type of competitors that we're dealing with.

Okay. That's helpful. Thanks. Thank you.

We have reached the end of our question and answer session. I will now turn the call back over to Shirley Stacy for closing remarks.

Thank you, everyone, for joining us today. We look forward to meeting with you at upcoming investor conferences and industry meetings. If you have any follow-up questions, please contact investor relations. Thanks, and have a great day.

Thank you. This concludes today's conference. You may disconnect your lines at this time. Thank you for your participation.