内容来源：https://www.wired.com/story/how-invisalign-became-the-worlds-biggest-3d-printing-company/

内容总结：

隐形牙套巨头爱齐科技启动最大规模生产革新，3D打印技术或成行业新引擎

当被问及公司业务时，爱齐科技（Align Technology）首席执行官乔·霍根（Joe Hogan）总会看到人们恍然大悟的微笑。这家市值约120亿美元的公司，正是隐形矫正品牌隐适美（Invisalign）的母公司。如今，爱齐科技正启动其成立29年以来最大规模的生产工艺革新，旨在通过直接3D打印牙套，颠覆现有模式，进一步巩固其全球隐形正畸市场的领导地位。

从模具到直接打印：一场效率与成本的革命

目前，隐适美牙套的生产依赖于3D打印模具再进行真空压塑的复杂流程。霍根表示，新的直接3D打印技术有望简化这一“更长、更浪费”的过程。长期来看，这不仅能降低成本，使牙齿矫正治疗更为亲民，从而触达更多客户，也能提升公司利润。霍根自信地宣称，此举将使爱齐科技“毫无疑问”成为全球最大的3D打印机用户。

作为制造业资深人士，霍根在爱齐科技的十余年间，见证了公司股价在其任内翻了三倍。去年，公司处理了创纪录的260万例病例，全球累计用户已达2200万。爱齐科技几乎掌控了从口内扫描仪、AI治疗规划软件到生产设备的全链条。

材料突破是关键，市场扩张面临新挑战

直接打印技术的核心障碍在于材料。霍根透露，公司已通过收购奥地利公司Cubicure及其高粘度树脂处理技术，成功研发了性能不低于现有材料SmartTrack的专用树脂。目前挑战在于如何将实验室突破转化为日产百万副牙套的规模化生产，这涉及打印工艺、支撑结构设计、激光切割等一系列复杂的工程问题。

随着业务全球化，爱齐科技面临适应不同地区患者齿颌特征差异的挑战。霍根承认，公司正在投入大量资金扩大产品组合，以应对亚洲、中东等新市场的需求。同时，针对北美市场关于治疗价格的疑问，霍根解释，公司向医生收取的费用约占患者总费用的25%左右，最终定价由医生决定。运输成本是公司主要成本之一。

未来展望：自动化生产与市场教育

霍根展望，随着生产自动化程度提高，未来在美国本土制造牙套也成为可能。对于传统金属牙套是否会消失的问题，他认为隐适美在疗效、速度和舒适度上已具备替代优势，但最终选择权在患者和医生手中。

此外，霍根也回应了消费者关切。他明确建议用户不要戴着牙套进食，以免增加龋齿、牙齿永久性染色等风险。对于治疗过程中的疼痛预测，他表示利用AI技术进行分析是可行的方向。关于微塑料的担忧，他则强调公司产品所使用的材料均经过严格测试，确保安全无毒性。

这场生产变革若成功，不仅将重塑爱齐科技的生产线，也可能为整个齿科制造领域树立新的技术标杆。

中文翻译：

乔·霍根见过无数笑容。当人们问他在哪里工作时，他回答"爱齐科技"，对方总会追问："那是做什么的？"这家市值120亿美元的公司正是隐适美的缔造者——那种需要每天佩戴约22小时、通过物理作用缓慢矫正牙齿的透明塑料牙套。经历数月甚至数年的佩戴，这种牙套承诺赠予人们渴望展示的自信笑容。霍根见证过所有笑容，而他渴望看到更多。

这家由两位斯坦福商学院同窗于29年前创立的公司，正启动自成立以来最大规模的生产革新。爱齐科技准备直接3D打印其核心产品隐形牙套，摒弃霍根口中"更耗时、更浪费"的传统模具制造流程。成功的转型将长期降低生产成本，让牙齿矫正更亲民，从而为隐适美吸引更多客户，提升公司利润。

霍根表示，此举还将巩固爱齐作为全球最大3D打印机用户的地位。这位并非创始人或科学家的CEO已养蜂超过25年，尽管执掌过三家市值数十亿美元的国际企业，他甚至连维基百科词条都没有。但作为深谙塑料与3D打印的制造业老将，他在爱齐十余年的经历尤其珍贵。

在他任期内，公司股价翻了三倍，既熬倒了失败的初创对手，又超越了其他竞争者。去年爱齐处理了创纪录的260万病例，其中儿童青少年患者高达93.6万。全球已有2200万患者使用过爱齐日益丰富的牙套产品线。

公司掌控着生产流程的几乎每个环节：研发扫描患者牙齿的扫描仪、搭载AI的医生诊疗规划软件，以及即将用于直接生产牙套和保持器的方形机器。仅凭这些基础，霍根预期公司未来数十年都将持续增长。

上月，霍根在硅谷爱齐实验室接受《连线》专访，畅谈对未来发展的预测、给患者的建议，并解释为何认为记者最近的隐适美体验属于特例。

本次访谈经过精简编辑。

《连线》：您用过隐适美吗？您的牙齿状况如何？
霍根：来这儿之前我对牙齿一无所知，甚至不知道牙齿终生都在移动。入职后第一件事就是扫描牙齿并开始矫正治疗，这样才能真正了解产品。那是十年前的事了。我不能保证始终佩戴保持器，但我妻子一直坚持佩戴。有时我会对她说："凯特，你不用每晚都戴，隔天戴就行。"她总回敬："你又不是医生，乔，你只是公司管理者。"不过这段体验很棒。

在全球隐形牙套市场，隐适美占据60%至70%份额，但在整个牙科领域处于什么位置？
我们并非牙科公司，而是正畸企业。去年营收约40亿美元。若以正畸业务衡量，我们的对比对象应是传统钢丝牙套。目前没有能接近我们体量的对手。不想说得太商业——我们去年售出约30亿美元牙套和8亿美元扫描仪，保持器销售额约300万美元。正畸领域没有其他公司能达到这种规模。

为何其他公司未能取得你们这样的成功？
关键在于时间。我们率先实现了"大规模定制化"，能做到每日3D打印百万副不同的牙套。这耗费了我们数年摸索。初创时期每天处理5个病例就令人兴奋。当时3D打印主要用于原型制作，我们必须对设备进行大规模改造。

这个团队——在我加入前——就掌握了前所未有的规模化生产技术。我认为我们拥有巨大的先发优势，不仅体现在临床方案、材料科学和病例规划技术，更在于规模化生产的核心能力。

您的同事说贵公司可能是最大的3D打印设备用户。
不是可能，就是最大。（两位3D打印行业专家向《连线》证实，爱齐的内部打印产量确实全球第一）

年收入40亿美元的企业竟是最大用户，而非那些千亿级营收的公司，这让我很惊讶。
我初来时也感到不可思议。整个3D打印行业曾因无法实现规模化而陷入困境，只停留在吸引业余爱好者阶段。当时我发现我们并非直接打印牙套，而是打印模具再进行真空塑形。

在我成长年代，人们矫正牙齿多是为了美观而非治疗。如今美容需求与健康需求的比例如何？
过去三四年，功能性问题案例显著增加。我刚入职时主要针对美学需求，客户群以特定年龄段女性为主。

但随着行业更关注牙齿清洁的长期效果及牙缝维护（便于日常使用牙线），我认为未来会各占一半：年轻患者可能更在意美观，年长患者则更关注如何终身维护牙齿。

我在佩戴隐适美期间查阅疗效研究时发现，很多研究样本群体狭窄。贵司如何拓展研究范围，特别是在开拓全球新市场时？
进入中东、亚洲市场时，我们发现中国与日本的牙齿排列特征截然不同。技术必须适配这些差异。为此我们投入大量资金扩充产品组合。（霍根后续未指明涵盖广泛种族群体的具体公开研究）

您近期频繁提及青少年产品，是市场需求推动的吗？
如果您见过用于扩展儿童牙弓的Essix装置——1993年我小儿子就戴过。我记得自己晚上拒绝进他房间拧调节器，总是让妻子去："你更会哄他。"我就是这么懦弱。

拿着六角扳手进去，必须旋转360度，孩子会很疼。入职后我立刻想到这点并与团队讨论。我们设想开发夜间佩戴的牙弓扩展器，让调节更轻松。这能让家长和孩子摆脱每晚手动调节的痛苦。

北美市场最大的痛点之一是定价，尤其是牙科保险覆盖不全的情况。价格区间从3000到8000美元不等，而你们给医生的均价约1200美元。请解释定价逻辑。
请注意这是医疗器械，最终定价权不在我们。我们根据病例复杂程度（如所需牙套数量）向医生收费，由医生决定患者价格。正畸医生对青少年收费通常更高，认为治疗难度大。全科医生主要接诊成人，部分也接儿童，各有定价体系。我们的产品定价约占患者总费用的25%。

海外定价较低有时因为病例较简单，医生只需使用30副左右牙套而非完整方案，收费自然更低。但正畸本身确实昂贵耗时，属于最昂贵的治疗项目之一。

我们最大的成本项是物流。我们可能是全球最大的小件货品运输商之一，随着内部成本降低，运输成本占比越来越高。我们的利润率属于健康企业水平，表现良好但绝非暴利。

医生建议我佩戴牙套进食，但警告某些食物会染色。能否开发防染色塑料，让人能戴着牙套吃任何食物？
首先我建议不要戴着牙套进食。
您又不是医生，我不信您。
我们无法完全控制传递给患者的信息。但戴着牙套进食确实体验不佳。（霍根补充说这可能增加龋齿风险、导致牙齿永久性着色及影响牙套贴合度）

牙套外层是抓附牙齿的柔软聚氨酯，内层是提供矫治刚度的聚酯材料。要求产品既能有效移动牙齿又防染色，本身有些矛盾。

回到3D打印话题，您说正在尝试直接打印牙套。但听起来仍需在打印材料方面取得突破。
我们认为已掌握这种材料。这正是我们收购奥地利公司Cubicure的原因。过去无法直接打印牙套让我非常困扰。我们尝试与化工企业等各方合作研发，却找不到能实现的伙伴。最终我们聘请了自己的高分子化学家，逐步研发出兼具现有真空成型材料特性又适合3D打印的树脂。

完成材料研发后，我们意识到必须使用高粘度树脂。水性树脂无法满足我们应用所需的复杂材料特性与性能组合。Cubicure的专长正是处理高粘度性能树脂，因此我们收购了该公司。现有树脂性能已达到甚至超越当前使用的SmartTrack材料，且我们已建立量产流程。记住，我们每天需要生产百万副牙套，这种规模极其庞大，而我们拥有全新的生产工艺，目前正处于推进阶段。

规模化面临哪些挑战？是设备数量不足还是质量控制？
首先是如何优化打印方式以减少树脂消耗？垂直打印、水平打印还是侧向打印？浇口应该设在外侧、内侧还是标签面？用激光切割吗？

真空成型时代只需激光切割牙龈区域即可完成，现在则完全不同。这是极其复杂精妙的工程难题。我们必须确保投产后的盈利性。规模化后树脂成本会下降，但这需要数年时间。

人们需要担心咀嚼微塑料吗？
不需要。我在职期间从未接到相关投诉。深入研究会发现，关于微塑料毒性存在很多真伪难辨的说法。医疗领域广泛使用塑料，水中也普遍存在。不同塑料成分各异。我们筛选佩戴级塑料时，完全排除任何有毒成分，确保通过FDA等监管审批。产品绝不含有毒物质。

治疗过程中，我特别希望提前知道哪副牙套会最疼，这周会是难熬的一周吗？
真有趣，刚有人跟我说过同样的话，我儿子泰勒也这么说过。
英雄所见略同。如果收集足够数据，人工智能应该能解决这个问题。有些周我可以正常吃喝，有些周却疼得想撞墙。
我其实和研发副总裁斯里尼讨论过这事。第一次提出时他觉得不可思议，但现在有两个数据点，可以开始研究了。

这确实可行且对我们不算难事。我们能预判哪些大幅移动会引起不适，也清楚特定牙齿的敏感度。

关于疗效，我注意到去年"精修病例"发货量超13.6万，增长36%。这不是坏事吗？精修病例不该减少吗？
精修病例通常因患者未佩戴保持器导致牙齿重新拥挤，医生会订购5-15副牙套进行微调。

当前美国社会对制造业回流热情高涨。你们目前在墨西哥、波兰和中国生产，未来有可能在美国制造牙套吗？
有可能。劳动力是重要因素。随着自动化程度提高，在美国生产会更具可行性。时机成熟时我们肯定会考虑。毕竟我们讨论过的运输成本也是考量因素之一。

目前墨西哥华雷斯工厂需要多少员工？
数千人。
这太夸张了，不是全自动化生产吗？
天啊，这种规模的3D打印非常复杂。打印完成后需要装袋，有时还需特殊处理。虽然难以简单描述，但车间内部在很多方面类似好市多仓库。

但这不像iPhone那样有数百个组件，看起来很简单啊。
看似简单实则工艺精密。我们有回收树脂的离心机、清洗站，既要3D打印又要真空成型，还需要大量软件工程师支持。说起来容易做起来难。不过直接3D打印确实能减少劳动力需求。

作为美国公民，如果能为国家做贡献我会支持。但北美自贸协定多年来确实有益。我们只需做出对业务最有利的决策。

当前政治环境下，您提到FDA。您认为其认证目前仍具公信力吗？
我认为是。总体而言，FDA在专业层面非常可靠。如今大多数争议集中在疫苗领域，这超出了我的专业范畴。就我们与FDA的互动及材料检测流程而言，一切如常。我认可其充分性与有效性。历经多届政府，监管标准并未剧烈波动，我认为这很棒。疫苗问题留给更专业的人士探讨——这个群体非常庞大。

您认为传统金属牙套会消失吗？
难以预测。我们能实现钢丝牙套的所有功能，且速度更快、患者体验更舒适。但最终选择权在患者。我们会尽力说服他们。难以想象二十年后人们还会佩戴金属牙套，因为这并非必要。但或许有人更倾向传统方式，或医生只习惯那种技术。我完全尊重自由选择。

英文来源：

Your colleague was saying that you're probably the largest user of 3D printing machines.
Not probably. By far. [Two 3D printing industry experts tell WIRED they agree that Align prints more parts in house than anyone in the world.]
That seems crazy to me that a $4 billion business is the biggest consumer, not one of the businesses that have hundreds of billions of dollars in revenue.
That seemed crazy to me when I walked in too. That whole industry got lost because it really wasn't scaling. It was trying to appeal to a whole number of hobbyists. When I came in here, I realized that we really didn't 3D print those aligners—that we were 3D printing molds and vacuum-forming a plastic over them.
When I was growing up, people were trying to straighten their teeth to have better smiles, not necessarily resolve a medical issue. How many cases these days are for beauty versus health?
Over the last three or four years, I'd say we have many more that have to do with functionality. When I walked in, we primarily were about aesthetics, and our demographic would've been women within a certain age group.
But the industry became more aware about the long-term viability of your ability to clean teeth and having spaces between them, so you can floss on a regular basis. As you go forward, I think it'll end up being 50-50 where the younger patients will probably be worried more about aesthetics and the older patient is going to be worried about how do I maintain my teeth for life?
When I was going through the Invisalign process, I was looking at studies on the efficacy of Invisalign to understand if it is as good as braces, and it seemed like a lot of those studies were done on a narrow demographic group. What are you doing to expand the research, especially as you go into new markets around the world?
As you move into areas in the Middle East, in Asia, you see China is completely different from Japan in the sense of the way their teeth align or don't align. We had to adopt our technology around those things. What we do about being able to address these other demographics or other nationalities is we have to put a ton of money into expanding our portfolio of products. [Hogan later declined to point to specific public studies with broad racial demographics.]
You've spent a considerable time talking about teens and kids products recently. Was someone asking for these things?
If you ever saw an Essix device that they used to expand kids’ palates, I had that in 1993 with my younger kid. I remember refusing to go into his bedroom at night and turn that crank. I'd send my wife in. “You have a better way with him.” That's what a coward I am.
You walk in there with this Allen wrench, and you have to turn that thing 360 degrees. It hurts. When I came here I remember thinking about that and talking to the team. We had ideas that we could put in a palate expander every night and make that move. And so I thought what we were addressing with that is a way to … have it much easier on parents and kids than turning that screw every night.
One of the biggest frustrations, at least in the North American market, is the pricing, especially with the way dental insurance works, or doesn't work. Like the price ranges. I saw anywhere from $3,000 to $8,000. Your average selling price to doctors is about $1,200. But help me understand the pricing.
Remember, this is a medical device that, in the end, we don't set the price. We charge a doctor for that particular case, how many aligners is it going to be or whatever. A doctor decides what they are going to charge a consumer. Orthos tend to charge more for teens, because they think teens are more difficult. Most of the general practitioners would primarily do adults, but some do kids, and they have their own pricing structure. We set the price for our product line. It's probably in the end 25 percent of what the total price will be.
When we say that overseas we charge less, that's sometimes because they're moderate cases. They don't want to do a full case. They just want to do 30 aligners or so. The doctors can charge less too because they're not doing a full case. But orthodontics is expensive. It really is. And it takes time. It is one of the most expensive procedures that you can get.
One of our biggest costs is just shipping. We're probably one of the largest small volume shippers in the world, and it's getting to a point as we've reduced our internal costs that a lot of what we do is transportation costs. If you look at our margins, you'd say they’re margins of a good company. It does well, but not extravagant margins.
I was encouraged to eat with my aligners and warned that certain foods would stain them. Is there a way to develop a plastic that doesn't stain so you can eat anything with them in?
First of all, I would tell you, don't eat with your aligners.
You're not a doctor. I'm not trusting you.
We can't control exactly what's conveyed to patients at times. But no, I'd say that that's not a good experience. [Hogan later adds that eating with aligners could increase the risk of cavities, permanent discoloration of teeth, and compromising the fit.]
The outsides are polyurethane, very soft plastics, so it can grab your teeth and hold them. The inside’s polyester. It gives you the rigidity to move it. It's kind of an oxymoron to say, give me a product that really can move my teeth and won't stain.
Going back to 3D printing, you've said you’re trying to directly print the aligners. But it sounds like you still need to have a breakthrough in terms of a material that'll go into these machines and be able to do that.
We feel we have that material. We do. That's why we bought Cubicure in Austria. It bothered me to death that we couldn't 3D print an aligner. We tried to work with chemical companies, everyone, to make this, and we couldn't find anyone that could do this. We hired our own polymer chemist, and then over time, we figured out how to make a resin that would have the properties of our current material that we vacuum form but be able to 3D print.
Once we had that material science done, we knew it was going to have to be high viscosity. Watery resins cannot deliver the combination of complex material properties and performance characteristics required for our applications. And that's why we bought Cubicure, because they have machines that know how to process high viscosity, performance resins. We have a resin we want, and that resin is as good or better than SmartTrack [Align’s current material]. And then we have a process to make aligners. Remember, we have to make a million of these a day. That kind of scale is monstrous, and we have a brand-new process. That's what we're going through now.
But what is the scaling challenge here? Is it just making enough of the machines? Is it getting quality control?
First of all, how do you print these things to limit the amount of resin that's used on them? Do you print them vertically? Do you print them horizontally? Do you print them sideways? Where do you put the runners, where the material actually goes into? Do you put it on the outside? Do you put it on the inside? Do you put it on the label side? Do you cut it with lasers?
When we vacuum formed, all you had to do was laser the gingival area, and you were done. In this case, it's a completely different story. It's a really dynamic and incredible engineering problem. We certainly have to be efficient enough to make sure that when we go into the marketplace, that it's a profitable equation. At scale, we should get to a point where the resin is less expensive, and that will help. But that takes years.
Should people be worried about chewing microplastics?
No, we've never had one complaint about microplastics since I've been here. If you do enough research, there’s a lot to be learned on what's real and what's not real, what's toxic. There's so much plastic use in medicine, and it's all over the place. Water. All these plastics have different compositions. When we start to look for a plastic that you're going to wear, we don't use any components that have any degree of toxicity, so that we know when we move into FDA approval or regulatory approval of it, we know we're good. We didn't put anything in there that would be considered toxic.
On the treatment plan, one thing that I would've loved is a way to know which aligner was going to be most painful. Was this week going to be a painful week or a not painful week?
That's funny. I just had another person tell me the same thing. My son told me that, Tyler.
Great minds think alike. It seemed to me that AI should be able to solve that if you collect enough data. There were some weeks that were like, I can eat anything, do anything. It's great. And other weeks I wanted to punch a wall.
I've actually talked to Srini [Kaza, Align’s executive vice president for research and development] about it. He looked at me cross-eyed the first time I told him. But now that I have two data points, I can draw a line through it.
Really, I think it's viable and it's not like it's a big deal for us. We know when a massive movement's coming that's going to upset you. And we know the delicacy of certain teeth that will be affected.
In terms of efficacy, one thing that I noticed was you said “touch-up cases” shipped last year were over 136,000, which was up 36 percent. Isn't that bad? Shouldn't you be doing less touch-up cases?
That touch-up is when someone didn't wear the retainers and the doctor said, “Oh, I have to touch that up because you got some lower crowding or whatever,” and they'll order anywhere between five and 10 to 15 aligners.
There's also a lot of passion, excitement right now in the country for bringing back manufacturing to the US. You’re in Mexico, Poland, and China currently. Is it ever going to be viable to make aligners in the US?
It could be. Labor is a huge component. As we get to manufacturing that's much more automated, having it in the United States could make sense. We'll certainly look at that as the time comes. Because I do think that, again, that shipment cost that we talked about, there is a piece to that, too.
How many people does it take to make these in Juarez, Mexico, right now?
Thousands.
That seems crazy. Isn't it just a machine doing all these things?
Oh my goodness, 3D printing at this level is a monster. You can 3D print these things, but remember, you have to take these aligners, and you have to put them in bags. Sometimes, you have to treat them in some way. It's hard to explain, but it looks like the inside of a Costco in a lot of ways.
But we're not talking about an iPhone. This seems so simple relative to something like an iPhone that has hundreds of components.
It does seem simple, but it's a very sophisticated process, too. We have centrifuges that are used to recapture resin. We have washing stations. You’re 3D printing and then your vacuum forming. Lots of software engineers down there as well. It sounds easier than what it is. But I do think as we direct 3D print, there'll be less of a labor component to it.
Look, I'm a US citizen. If I can support the country, I'll support it. But I feel like NAFTA's been a help over the years. We just want to do what makes sense for the business.
The other thing in politics right now, you mentioned the FDA. Do you even view that as a valid stamp of approval at the moment?
I do. In general, at a certain level, the FDA is very competent. Most of the argument with the FDA today has to do with vaccines. That's above my pay grade. As far as how we interact with the FDA, how they test our materials, that hasn't changed. I feel it's good and adequate. I've worked across a lot of administrations, and I haven't seen it change dramatically, which I think is great. The whole question on vaccines, I leave that to people that are smarter than me, which is a large group of people.
Do you think traditional metal braces ever go away?
I can't predict that. We can do everything wires and brackets can do. We can do it faster, and I think we can do it in a way that's more comfortable for patients. But patients are going to have to make that decision. We'll do everything we can to convince them. I can't imagine 20 years from now, you still have metal and wires on people's teeth, because it's really not needed. But there might be people that think that they'd rather have wires and brackets or doctors only want to work with that. And I'm all for free choice.