3D printing firm Voodoo supplying dental aligners

Brooklyn, N.Y.-based Voodoo Manufacturing Inc. is entering the orthodontics market with 3D printing and thermoforming services to produce clear dental aligners for its partners to sell directly to consumers wanting to treat mild to moderate crooked or gapped teeth.

Founded in 2015, Voodoo expanded this year with a new wing of Formlab 3D printers and an automated post-processing line able to produce more than 20,000 flexible and discreet polyurethane aligners every month.

Voodoo is taking on partners to sell its clear dental aligners under their private labels. The company's first major direct-to-consumer partner is Draper, Utah-based Smilelove LLC, which has been selling at-home teeth straightening kits and aligners since 2017.

Clear dental aligners generally come in a series of 10 to 50 sets that slip over teeth and move them in stages to straighten positions or close gaps. Each stage takes about two weeks. The patient then uses the next set of aligners until the desired look is achieved.

Smilelove and other newcomers like Orthly, Candid and Uniform Teeth are poised to take a bite out of the sales of Invisalign, a brand leader that saw $2 billion in sales in 2018 through dentists and orthodontists, as well as SmileDirectClub Inc., which started selling clear dental aligners online and at drugstores in 2014.

SmileDirectClub made an initial public offering Sept. 12 with the price on the Nasdaq set at $23 per share to raise $1.3 billion. That gives the teledentistry pioneer a valuation of $9 billion.

Nearly undetectable and removable, clear dental aligners are gaining popularity as a remedy for some teeth problems that can get results with less pain and hassle. There are no orthodontist appointments to keep or metal wires and brackets to tighten and replace. The plastic aligners apply a gentle force to move teeth into position.

Voodoo Manufacturing CEO Max Friefeld sees many opportunities for his company and partners. He points to demand from people who had braces in the past but didn't wear their retainer to maintain the alignment and now want to straighten their teeth again. While the market is growing rapidly, Friefeld said it is hampered by a lack of modern manufacturers capable of delivering such personal and unique products at scale.

"We're offering a fully automated digital process to anybody who wants to start an aligner brand," Friefeld said in a phone interview. "We also sell directly to dentists and orthodontists. We're really hoping to open the market and level the playing field here."

On the market for 20 years, Invisalign products are designed and manufactured by San Jose, Calif.-based Align Technology Inc., which established itself as the premier provider of clear dental aligners, with the technology to handle complex cases. However, in the last couple years, about 40 of Align Technology's 400 U.S. patents began expiring, including several that protected the process to digitally plan and manufacture the clear aligner sets.

"This industry started in the '90s when Invisalign invented clear aligners. From day one, they used 3D printers to make them. It was one of their main innovations," Friefeld said. "As Invisalign's patent started expiring in the last few years, competitors showed up."

There are millions of patients worldwide who could benefit from six- to 18-month aligner treatments that new companies can address, Friefeld said.

"Voodoo can support that new target of growth," he added. "We essentially built our factory a year ago to produce clear aligners at low cost. Using automation, software and technology, we can bring the cost down and bring quality up."

Invisalign treatment costs $3,000 to $8,000, while Smilelove charges $1,895 for an at-home impression kit, aligners, retainers and whitening if bought as a package. SmileDirectClub treatment also costs $1,895.

Smilelove aligners sales have been growing and orders were taking longer to fill, so company officials sought a partner that could produce the devices quickly.

"Long delivery times for aligners have consistently been a hurdle, but thanks to our partnership with Voodoo, we'll be able to cut the times down from 2-5 weeks, to just 2-5 days. We can't wait to bring this kind of groundbreaking speed and quality to our customers." Smilelove founder Spencer Grider said in a news release.

To get started, Smilelove patients order a kit to make molds of their teeth at home. They get instructions and materials for two upper and two lower impressions. The process takes about 25 minutes and entails filling impression trays with putty and biting into them to create the molds.

The molds, along with photos of the teeth, are then mailed to Smilelove's dental team, which includes licensed dentists in every state. The team assesses the current state of the patient's teeth and medical history to determine if the person is a good candidate for the treatment. If the case is approved, the dental impressions are scanned to create a digital 3D representation of the teeth. Technicians then use software to determine all the stages between the current and desired positions. Customers get to see the preview images of what their straightened teeth will look like at the end of the process as well as the steps in between.

If the customer wants to proceed, a unique set of trays is manufactured for them. That's where Voodoo comes in.

"We're the manufacturer behind the scenes," Friefeld said. "In a way, we think of ourselves as a generic drugmaker. If Invisalign is Tylenol, we're Walgreens' ibuprofen. Our focus is producing a product of the same quality or better in certain circumstances and offering it at a lower price."

To get into the hands and mouths of customers as quickly as possible, Voodoo invested in 21 FormLab 2 printing machines that can make 20,000 molds a month. The company then automated other parts of the process with two five-axis CNC mills for trimming and a laser marking every aligner with a unique identifying code. Polishing, cleaning and sorting also is automated.

Recent advancements in computer-aided design software and 3D printing are used to make the molds for the thermoforming process. The orthodontic software generates standard format 3D files to physically produce each mold in the treatment plan.

Voodoo thermoforms a plastic sheet over each mold using Zendura-brand polyurethane resin from Fremont, Calif.-based Bay Materials LLC. The aligners are then trimmed, polished, sorted, bagged and sent to partners to deliver to customers for confirming fit and design.

Friefeld said Voodoo's cutting-edge factory addresses a production pain point in the teledentistry and clear dental aligner markets.

"Our goal is to scale with our customers so they don't have to think about longer lead times," Friefeld said. "Our service contracts actually have a refund where we pay them for every single day an order is late over a week. We hold ourselves to a very high standard."

Through innovation, Voodoo found a way to get customers their first month of aligner treatment in as little as two days, Friefeld added.

"We're very excited about helping our partner Smilelove differentiate itself with speed," he said. "This is a quickly growing market. If you talk to customers, their goal is to just get through it. They want that smile on the other side and waiting a few weeks can be a problem. They have weddings and job interviews coming up and a lot of reasons to want to begin treatment. Our goal is to help them through it as quickly as possible."