Two Decades of Evolution and Future Outlook: 'White Paper on China's Clear Aligner Industry' Officially Released

On June 2, at the 10th A-TECH Conference, Angelalign, in collaboration with CIC Consulting, released the White Paper on China’s Clear Aligner Orthodontics Industry (hereinafter referred to as the “White Paper”). The document comprehensively chronicles the development of China’s clear aligner orthodontics industry over the past two decades and provides a holistic outlook on future industry trends, analyzed across five dimensions: background, industry landscape, technology, talent, and trends.

The white paper took four months to compile, involving a review of 2.2 million words of literature and interviews with nearly 50 physicians and industry experts, culminating in a 90-page panoramic report.

At the A-TECH Conference, Angelalign specially invited Zhao Wenyi, Co-Head of Healthcare Investment Banking for Goldman Sachs Asia (ex-Japan) and Managing Director, to share his insights and perspectives on trends in China’s clear aligner industry.

Zhao Wenyi stated that the clear aligner industry is a microcosm of the rapid development of China’s healthcare sector. Driven by digitalization as its growth engine, various healthcare subsectors have achieved more efficient data management, more accurate diagnostics, and more accessible medical services. The unique medical heritage, pioneering spirit, and innovative drive of China’s leading clear aligner companies will propel the global development of digital orthodontics across multiple commercial and technological dimensions.

Zhao Wenyi highlighted two major trends: First, with increased R&D investment and case accumulation by Chinese brands, the application scenarios for clear aligner diagnosis and treatment are continuously expanding, gradually shifting from general orthodontic correction toward preventive and interceptive treatments. Second, Chinese brands are accelerating their overseas layout and expansion, supporting international strategic deployment through various forms and providing differentiated products and medical services tailored to different countries and regions abroad. The future of China’s orthodontics industry is vast and promising.

The Chinese clear aligner industry emerged in the early 2000s. Professor Wang Bangkang from Capital Medical University and Professor Yan Yongnian from Tsinghua University, as pioneers of clear aligner technology in China, initiated the development of the country’s clear aligner treatment sector.

In 2003, Angelalign obtained China’s first invention patent for clear aligner technology and secured the country’s first registration certificate for bracketless clear aligners. As a field with high technical barriers, the clear orthodontics industry initially saw only a few brands enter and successfully obtain Class II medical device registration certificates.

In the early stages, invisible orthodontic technology was limited to aligning teeth in simple cases. In 2004, Dr. Tian Jie joined Angelalign as Chief Medical Officer, transforming orthodontic principles into digital oral healthcare technologies that integrate interdisciplinary fields such as biomechanics and computer science. He dedicated himself to research and development for complex extraction cases, achieving breakthrough results.

In 2010, Dr. Tian Jie published the first successful clear aligner case involving tooth extraction in China in the Chinese Journal of Orthodontics. As cases involving extractions were gradually mastered, China’s clear aligner industry entered a phase of rapid growth.

By the end of 2015, the cumulative number of clear aligner orthodontic cases in China reached 100,000, marking the onset of a period of rapid growth; by 2020, the cumulative case volume in China had surpassed one million. In 2021, Angelalign, known as “China’s First Clear Aligner Stock,” was listed on the Hong Kong Stock Exchange, further prompting capital markets to reassess the value of this sector, with multiple clear aligner manufacturers securing financing in the same year.

The development of China’s clear aligner industry has been propelled by multiple factors, including policy support, capital investment, and market dynamics. On the supply side, the construction and advancement of the dental healthcare system, deepening digital penetration, and product innovation in clear aligners jointly drive industry growth. On the demand side, increased household affordability, the emergence of preventive oral health needs, and heightened aesthetic awareness have injected long-term momentum into the industry.

According to NMPA registration data, there are currently nearly 200 registered clear aligner products without brackets. However, the overall clear aligner market in China has formed a relatively stable “duopoly” pattern, with concentration trending toward the two leading manufacturers: Angelalign and Invisalign. Based on case volume, Angelalign ranked first in the Chinese market in 2021 with a 41.1% market share, and retained its top position in 2022 as its market share expanded to 41.7%, nearly 10 percentage points ahead of the second-place competitor.

Currently, the capital market is gradually returning to rationality. Based on research into the development trends across all segments of the clear aligner industry, we explore investment opportunities in various sub-sectors of China’s oral healthcare market.

In the evolution of clear aligner orthodontics, digitalization serves as the core driving force. The complete clinical workflow for clear aligner orthodontics comprises six stages: patient consultation, assisted diagnosis, treatment planning, approval for production and delivery of therapy, follow-up visits/consultations, and retention of results. Within this clear aligner orthodontics industry chain, each segment is undergoing continuous iteration and development.

Early-mover companies have established competitive barriers by leveraging their continuously upgraded and innovative technological systems, product portfolios, and commercial capabilities.

From the perspective of R&D systems, although the product technologies of clear aligner manufacturers are all based on five core disciplines—clinical dentistry, biomechanics, computer science, materials science, and intelligent manufacturing—their underlying logics differ across companies, leading to distinct core competitive barriers.

Taking Angelalign as an example, built upon the foundations of five major disciplines, Angelalign adheres to the concept of "biological holism." Based on these five disciplines, it has established three major platforms: the ME biological data platform, the masterForce® biomechanics research platform, and the masterControl® materials science research platform, thereby developing diverse orthodontic treatment solutions. On this basis, Angelalign has constructed a diversified product portfolio covering aligner products, digital solutions, membranes, and tools, to assist clinicians in helping patients achieve orthodontic goals characterized by health, balance, stability, and aesthetics.

Currently, the applications and solutions of the Angelalign System are gradually evolving toward broader indications and improved treatment efficiency. Digital diagnostic and therapeutic tools—including iOrtho, the Intelligent Root System (IRS), and the digital remote solution MOOELI®—demonstrate high clinical usability, empowering clinicians to achieve efficient diagnosis and treatment.

Driven by continuous innovation rooted in medical research, Angelalign has expanded the boundaries of orthodontic diagnosis and treatment. It has launched multiple representative technologies with industry-leading capabilities in innovative areas such as special tooth movements (including extraction cases, distalization of molars, and torque control), functional appliance therapy, and adjunctive treatment modalities.

As a highly interdisciplinary field, the advancement of clear aligner orthodontics requires collaborative efforts from professionals across five major disciplines. Clinical oral healthcare providers, represented by orthodontists, serve as the backbone of China’s orthodontic industry.

Due to the late start in discipline construction and the inherent complexity of orthodontic education, China continues to face a significant shortage of oral healthcare professionals, particularly specialists in orthodontics. According to WHO data, the current density of dentists in China is only slightly above the global average. In comparison with developed countries, there remains a substantial gap between China and nations such as the United States and Japan in terms of the population density of dentists and physicians. Consequently, the supply side is insufficient to bridge the considerable demand gap.

On the one hand, policymakers, academics, and industry players are jointly exploring a more scientific talent development system tailored to China’s national conditions. The concept of returning to the essence of orthodontic care and emphasizing the importance of systematic learning is gradually becoming a trend, with clear aligner manufacturers such as Angelalign providing more opportunities and resources for systematic education. On the other hand, the widespread adoption of digital clear aligner technology can effectively expand physicians’ “service radius,” thereby alleviating the shortage of professional talent to some extent.

Meanwhile, thanks to the joint efforts of Chinese orthodontic scholars and domestic enterprises, the gap between China’s orthodontics discipline and the international forefront is continually narrowing. Notably, China has achieved overtaking on a bend in the management of complex clear aligner cases. At the same time, Chinese orthodontic scholars and industry professionals are increasingly participating in the international market, thereby enhancing China’s influence in the global orthodontic academic community.

In the fields of biomechanics, materials science, computer science, and intelligent manufacturing—closely related to clear aligner orthodontics—China has cultivated a large pool of high-end talent, benefiting from the rapid development and catch-up of its scientific and technological capabilities. However, it will still take time to nurture interdisciplinary professionals with innovative research and development capabilities.

As a rapidly growing segment within the oral healthcare services market, the penetration rate of clear aligner orthodontics among all orthodontic cases has risen from only about 3% in 2015 to approximately 14% in recent years. Measured by end-user prices, the market size for clear aligner orthodontic medical services has expanded rapidly over the past few years, with a compound annual growth rate (CAGR) exceeding 30%, indicating that clear aligner therapy is accelerating its penetration into orthodontic treatment in China.

Globally, the clear aligner orthodontics market is poised for continued growth. The number of clear aligner orthodontic cases worldwide has steadily increased from fewer than 1 million in 2015 to nearly 4 million in 2022, representing a compound annual growth rate (CAGR) of over 25%. By 2030, the global number of clear aligner orthodontic cases is projected to reach approximately 10 million.

With its low penetration rate and high growth potential, the Chinese market offers substantial future opportunities and is expected to maintain a growth rate above the global average. From 2015 to 2022, the compound annual growth rate (CAGR) of clear aligner treatment cases in China exceeded 35%. The CAGR for clear aligner treatment cases in China is projected to remain above 20% from 2022 to 2030.

Technological advancement remains the core driving force. Currently, the global industry is conducting in-depth research in materials science, biomechanics, intelligent manufacturing, and computer science to explore the next paradigm shift in bracketless clear aligner technology. In the fields of materials science and biomechanics, material innovations are poised to fundamentally transform clear orthodontic treatment; future efforts should focus on both incremental improvements to existing materials and “zero-to-one” breakthrough innovations. In intelligent manufacturing, direct 3D printing may become the next transformative development in clear orthodontics, with related research underway. In computer science, computational technologies will continue to deeply empower every segment of the clear aligner technology ecosystem, thereby facilitating industry growth.

Innovation in governance models has also become a growth engine for the clear aligner industry. Over the past two decades, Angelalign has shouldered the responsibility of pioneering China’s clear aligner sector, driving not only transformative advances in technological productivity but also serving as a paradigm of modern corporate governance and a testament to managerial productivity. Angelalign epitomizes the global expansion of Chinese orthodontics.

Furthermore, amid intense industry competition, China’s clear aligner sector is placing greater emphasis on intellectual property protection and technical standardization. With standards continuously being refined and elevated, the industry as a whole is progressing in a positive and rapid direction.

Looking ahead, from the demand side, oral health awareness and aesthetic needs across all age groups will gradually shift from “treatment” to “prevention,” leading to earlier prevention and treatment in orthodontics. From the supply side, the accessibility of clear aligner therapy is steadily improving. The extensive primary care market demand in China is poised for significant release, with clinically experienced product technologies, comprehensive talent development, and patient-centered treatment designs serving as strong support for this grassroots market.

In the global market, an increasing number of emerging markets are demonstrating robust growth potential. As Chinese manufacturers become more mature, they are advancing further onto the international stage, making “Chinese Orthodontics Influencing the World” a current reality.

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