愛齊科技 (ALGN) 2023 Q4 法說會逐字稿

Good afternoon, and thank you for joining us. I'm Shirley Stacy, Vice President of Corporate Communications and Investor Relations.

下午好，感謝您加入我們。我是雪莉‧史黛西，企業傳播與投資人關係副總裁。

Joining me for today's call is Joe Hogan, President and CEO; and John Morici, CFO. We issued fourth quarter and full year 2023 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 1 month.

與我一起參加今天電話會議的是總裁兼執行長 Joe Hogan；和財務長約翰·莫里奇。我們今天透過美國商業資訊發布了 2023 年第四季和全年財務業績，該業績可在我們的網站 Investor.aligntech.com 上取得。今天的電話會議採用音訊網路直播，並將在我們的網站上存檔約 1 個月。

As a reminder, the information provided and discussed today will include forward-looking statements, including statements about Align's future events and product outlook. 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 statements. We have posted historical financial statements, including the corresponding reconciliations, including our GAAP to non-GAAP reconciliation, if applicable, and our fourth quarter and full year 2023 conference call slides on our website under quarterly results. Please refer to these files for more detailed information.

提醒一下，今天提供和討論的資訊將包括前瞻性陳述，包括有關 Align 未來事件和產品前景的陳述。這些前瞻性陳述僅是預測，涉及風險和不確定性，這些風險和不確定性在我們向美國證券交易委員會提交的最新定期報告中進行了更詳細的描述，該報告可在我們的網站和sec .gov 上獲取。實際結果可能會有很大差異，Align 明確表示不承擔更新任何前瞻性陳述的義務。我們已經發布了歷史財務報表，包括相應的調節表，包括我們的 GAAP 與非 GAAP 調節表（如果適用），以及我們網站上季度業績下的第四季度和 2023 年全年電話會議幻燈片。請參閱這些文件以獲取更多詳細資訊。

With that, I'll turn the call over to Align Technology President and CEO, Joe Hogan. Joe?

接下來，我會將電話轉給 Align Technology 總裁兼執行長 Joe Hogan。喬？

Thanks, Shirley. Good afternoon, and thanks for joining us.

謝謝，雪莉。下午好，感謝您加入我們。

On our call today, I'll provide an overview of our fourth quarter and full results and discuss a few highlights from our 2 operating segments, Systems, Services and Clear Aligners. John will provide more detail on our Q4 financial performance and comment on our views for 2024. Following that, I'll come back and summarize a few key points and open the call to questions.

在今天的電話會議上，我將概述我們的第四季度和完整業績，並討論我們兩個營運部門（系統、服務和透明對準器）的一些亮點。 John 將提供有關我們第四季度財務業績的更多詳細信息，並評論我們對 2024 年的看法。隨後，我將回來總結一些要點並開始提問。

I'm pleased to report fourth quarter results with better-than-expected revenues and earnings. As of the end of Q4, we achieved several major milestones, including 17 million Invisalign patients treated, including 4.7 million teens, plus 4 million Vivera Retainer cases and over 100,000 iTero scanners sold. And for the full year -- fiscal year 2023, total revenues exceeded our prior outlook, and we delivered fiscal 2023 non-GAAP operating margin above 21%.

我很高興地報告第四季度的業績，收入和收益都比預期好。截至第四季末，我們實現了幾個重大里程碑，包括治療 1700 萬 Invisalign 隱適美患者（其中包括 470 萬青少年）、400 萬個 Vivera Retainer 病例以及售出超過 10 萬台 iTero 掃描儀。 2023 財年全年，總收入超出了我們先前的預期，我們實現了 2023 財年非 GAAP 營業利潤率超過 21%。

For Q4, total revenues were up 6.1% year-over-year, reflecting increased Systems and Services revenues. Strength in Clear Aligner volumes for teens and international doctors as well as continued growth from Invisalign touch-up cases, under our Invisalign Doctor Subscription Program, or DSP. Our Q4 Systems and Services revenues were up year-over-year, primarily due to increased services, CAD/CAM and nonsystems revenues, including scanner leasing and rental programs and certified preowned scanner sales.

第四季總營收年增 6.1%，反映出系統和服務收入的增加。在我們的 Invisalign 隱適美醫生訂閱計劃 (DSP) 下，青少年和國際醫生的透明矯正器銷量強勁，並且 Invisalign 隱適美修補案例持續增長。我們第四季度的系統和服務收入年增，主要是由於服務、CAD/CAM 和非系統收入的增加，包括掃描器租賃和租賃計劃以及經過認證的二手掃描器銷售。

Q4 total Clear Aligner shipments were slightly lower year-over-year. On a year-over-year basis, Clear Aligner volumes were down for the Americas and EMEA regions and were up for the APAC region. For Q4, Clear Aligner shipments include approximately 20,000 Invisalign DSP touch-up cases, primarily in North America, an increase of more than 60% year-over-year from Q4 '22. DSP continues to be well received by our customers and is currently available in the U.S. and Canada, Iberia and Nordics and most recently, the U.K. We're excited that DSP is proving helpful to doctors and their patients as we continue to expand the program.

第四季透明矯正器總出貨量較去年同期略有下降。與去年同期相比，美洲和歐洲、中東和非洲地區的透明矯正器銷量有所下降，而亞太地區的銷量則有所上升。第四季度，Clear Aligner 的出貨量包括約 20,000 個 Invisalign DSP 修補盒，主要在北美，比 22 年第四季年增超過 60%。 DSP 繼續受到我們客戶的好評，目前在美國和加拿大、伊比利亞和北歐地區以及最近在英國推出。我們很高興隨著我們繼續擴展該計劃，DSP 被證明對醫生及其患者有幫助。

For fiscal 2023, total Invisalign DSP touch-up cases shipped were 73,000, up 85% year-over-year. For non-case revenues, Q4 was up 13.3% year-over-year, primarily due to continued growth from Vivera Retainers along with Invisalign DSP retainer revenues.

2023 財年，Invisalign 隱適美 DSP 修補盒的總出貨量為 73,000 個，較去年同期成長 85%。對於非案例收入，第四季度年增 13.3%，主要得益於 Vivera 維持器和 Invisalign DSP 維持器收入的持續成長。

On a sequential basis, Q4 total revenues were down slightly, 0.4%, primarily reflecting anticipated seasonally lower teens case starts, especially in the U.S. ortho channel and unfavorable foreign exchange offset somewhat by increased revenues from System and Services as well as an increase in Clear Aligner volume for adults and noncomprehensive cases and stronger volumes from Canada and the EMEA region.

以環比計算，第四季度總收入小幅下降0.4%，主要反映了預期的青少年案件開工率季節性下降，特別是在美國正交頻道，以及系統和服務收入的增加以及Clear 的增加在一定程度上抵消了不利的外匯匯率。針對成人和非綜合病例的矯正器數量以及來自加拿大和歐洲、中東和非洲地區的更大數量。

Q4 total Aligner shipments were slightly lower sequentially. On a sequential basis, Clear Aligner volumes were down for the Americas and APAC regions and were up sequentially for the EMEA region. The December gauge practice analysis tool that collects and consolidates data from approximately 1,000 orthodontic practices across the U.S. and Canada reported year-over-year decline for new patients, total exams and total starts, particularly among teens and kids. It also shows a year-over-year decline for wires and brackets and total Clear Aligner starts with Invisalign case starts better than the Clear Aligner brand.

第四季對準器總出貨量較上季略有下降。美洲和亞太地區的 Clear Aligner 銷量則是環比下降，而歐洲、中東和非洲地區的銷量則是環比上升。 12 月的測量實踐分析工具收集並整合了美國和加拿大約 1,000 家正畸診所的數據，報告顯示新患者數量、總檢查次數和總開始次數同比下降，尤其是在青少年和兒童中。它還顯示了鋼絲和托架的同比下降，並且隱形矯正器的總開工率，Invisalign 隱形矯正器的開工率優於透明矯正器品牌。

And the teen segment for Q4, a 197,000 teens and younger patients started treatment with Invisalign Clear Aligner Systems, up 6% year-over-year and were a record number of teen cases shipped compared to prior fourth quarters. Q4 teens starts were down sequentially, consistent with historical seasonality, primarily in China as well as seasonally fewer teen starts in North America compared to Q3.

在第四季的青少年細分市場中，有197,000 名青少年及年輕患者開始使用Invisalign 隱適美透明矯正器系統進行治療，年增6%，與前第四季相比，青少年病例出貨量創歷史新高。第四季度青少年入學人數持續下降，與歷史季節性一致，主要是在中國，與第三季相比，北美青少年入學人數季節性減少。

For fiscal 2023, total Invisalign Clear Aligner shipments for teens and younger patients reached a total of 809,000 cases, up 8% compared to the prior year and made up 34% of total Clear Aligner shipments. During Q4, we announced that the U.S. Food and Drug Administration cleared the Invisalign Palatal Expander System, we call it IPE, Invisalign Palatal Expander for commercial availability in the United States. The FDA 510(k) clearance is for broad patient applicability, including growing children, teens and adults. Full early intervention treatments such as Phase I or early interceptive treatment, makes up about 20% of the orthodontic case starts each year and is growing. Together with Invisalign First Aligners, IPEs provide doctors with a solution set to treat the most common skeletal, dental malocclusions in growing children.

2023財年，青少年和年輕患者的 Invisalign 隱形矯正器總出貨量達到 809,000 例，比前一年增長 8%，佔透明矯正器總出貨量的 34%。在第四季度，我們宣布美國食品藥物管理局批准了 Invisalign 隱適美顎擴張器系統，我們稱之為 IPE，Invisalign 隱適美顎擴張器在美國上市。 FDA 510(k) 授權適用於廣泛的患者，包括成長中的兒童、青少年和成人。全面的早期介入治療，例如第一階段或早期攔截治療，約佔每年開始的正畸病例的 20%，並且還在不斷增長。 IPE 與 Invisalign First Aligners 一起為醫生提供了一套解決方案，用於治療成長兒童中最常見的骨骼、牙齒咬合不正。

The addition of mandibular advancement features to Invisalign aligners also provides doctors with more options for treating skeletal, dental joint balances and bite correction and for their growing patients during their teenage years. Essentially, we now have an Invisalign digital treatment solution for every phase of treatment.

Invisalign 隱適美矯正器增加的下顎前移功能也為醫生提供了更多治療骨骼、牙關節平衡和咬合矯正以及青少年時期成長中患者的選擇。本質上，我們現在為治療的每個階段提供了 Invisalign 隱適美數位治療解決方案。

IPE is currently available on a limited basis in Canada and the United States, and we recently received regulatory clearance in Australia and New Zealand where we anticipate commercialization in Q2. We expect IPE to be available in other markets pending future applicable regulatory approvals.

IPE 目前在加拿大和美國有限提供，我們最近在澳洲和紐西蘭獲得了監管許可，我們預計在第二季度實現商業化。我們預計 IPE 將在其他市場上市，等待未來適用的監管機構批准。

We're also launching ClinCheck smile video, the next generation of In-Face digitalization with AI-assisted video that is expected to be available to all doctors who use the Invisalign Practice App and ClinCheck treatment planning software. This new tool is designed to help improve patients' understanding and of the confidence in Invisalign treatment and is based on iTero Intraoral Scanner and doctors ClinCheck plan for Invisalign treatment.

我們還推出了 ClinCheck 微笑視頻，這是具有人工智能輔助視頻的下一代面部數位化技術，預計所有使用 Invisalign Practice App 和 ClinCheck 治療計劃軟體的醫生都可以使用。該新工具旨在幫助提高患者對 Invisalign 隱適美治療的了解和信心，並基於 iTero 口內掃描儀和醫生的 Invisalign 隱適美治療 ClinCheck 計劃。

ClinCheck smile video simulates the doctor's ClinCheck treatment plan with a short video of a patient's face, and they talk and smile, which helps patients visualize their potential new smile and can lead to a higher patient treatment acceptance. We expect to roll out ClinCheck smile video in Q1 '24 in North America and EMEA, followed by APAC later in the year.

ClinCheck微笑影片透過患者臉部的短影片模擬醫生的ClinCheck治療計劃，他們說話和微笑，這有助於患者想像他們潛在的新微笑，並可以導致更高的患者治療接受度。我們預計將於 24 年第一季度在北美和歐洲、中東和非洲推出 ClinCheck 微笑視頻，隨後於今年晚些時候在亞太地區推出。

Before I turn the call over to John for our fourth quarter financial review, I want to share one more exciting news. Today, we introduced the latest innovation in the iTero family of inter-oral scanners. The iTero Lumina inter-oral scanner designed to meet the needs of doctors and their patients by offering smaller wand with unparalleled data capture capabilities for effortlessly scanning by clinical members. The iTero Lumina Inter-oral scanner is a breakthrough technology. With 3x wider field of capture and a 50% smaller wand that delivers faster scanning, higher accuracy and superior visualization for greater practice efficiency. iTero Lumina quickly, easily and accurately captures more data while delivering exceptionally scanned quality and photorealistic images that eliminate the need for inter-oral photos altogether.

在我將電話轉給約翰進行第四季度財務回顧之前，我想分享一個更令人興奮的消息。今天，我們介紹了 iTero 系列口腔掃描儀的最新創新成果。 iTero Lumina 口腔內掃描儀旨在滿足醫生及其患者的需求，提供具有無與倫比的資料擷取功能的較小的掃描棒，供臨床成員輕鬆掃描。 iTero Lumina 口腔掃描儀是一項突破性技術。捕捉範圍擴大了 3 倍，掃描棒縮小了 50%，可提供更快的掃描速度、更高的準確性和卓越的視覺化效果，從而提高練習效率。 iTero Lumina 快速、輕鬆、準確地擷取更多數據，同時提供卓越的掃描品質和逼真的影像，完全消除了對口內照片的需求。

Doctors can now scan at twice the speed with a wide field of capture, multi-angled scanning and large capture distance, meaning they can capture more dentition in greater detail throughout the scanning process. To date, Align has filed over 30 patent applications covering technology related to the iTero Lumina inter-oral scanner. I believe iTero Lumina has the potential to set a new standard of care for dental practices by simplifying the scanning of complex oral regions while offering superior chairside visualization and more comfortable experience for patients, especially kids.

醫生現在可以以兩倍的速度進行掃描，具有寬捕捉範圍、多角度掃描和大捕捉距離，這意味著他們可以在整個掃描過程中更詳細地捕捉更多牙列。迄今為止，Align 已提交 30 多項專利申請，涵蓋與 iTero Lumina 口腔掃描儀相關的技術。我相信 iTero Lumina 有潛力透過簡化複雜口腔區域的掃描，同時為患者（尤其是兒童）提供卓越的椅旁視覺化和更舒適的體驗，從而為牙科診所製定新的護理標準。

Initial doctor feedback has been very positive, noting that iTero Lumina scanner is much faster, clear, less invasive for their patients and the imaging and visualization translates to better communications and patient experience. The iTero Lumina inter-oral scanner is available now with orthodontic workflows and will be available in the second half of 2024 restorative workflows, although we expect that GP practices can benefit now from the new scanning technology. A global broadcast to unveil iTero Lumina and provide attendees with insights and detailed information from our iTero team and early customer users is planned for February 15. Registration will open on February 1 and the link has been provided in our financial slides as well as in today's press release.

醫生最初的回饋非常積極，指出 iTero Lumina 掃描儀對患者來說更快、更清晰、侵入性更小，而且影像和視覺化可以轉化為更好的溝通和病患體驗。 iTero Lumina 口內掃描儀現已與正畸工作流程一起使用，並將於 2024 年下半年在修復工作流程中使用，不過我們預計全科醫生診所現在可以從新的掃描技術中受益。計劃於2 月15 日進行全球廣播，推出iTero Lumina 並向與會者提供來自我們的iTero 團隊和早期客戶用戶的見解和詳細信息。註冊將於2 月1 日開放，我們的財務幻燈片以及今天的財務幻燈片中均提供了此連結新聞稿。

With that, I'll turn the call over to John.

這樣，我就把電話轉給約翰。

Thanks, Joe.

謝謝，喬。

Now for our Q4 financial results. Total revenues for the fourth quarter were $956.7 million, down 0.4% from the prior quarter and up 6.1% from the corresponding quarter a year ago. On a constant currency basis, Q4 '23 revenues were impacted by unfavorable foreign exchange of approximately $12.8 million or approximately 1.3% sequentially and were favorably impacted by approximately $13.8 million year-over-year or approximately 1.5%. For Clear Aligners, Q4 revenues of $781.9 million were down 1.6% sequentially, primarily from lower volumes. On a year-over-year basis, Q4 Clear Aligner revenues were up 6.9% and primarily due to higher ASPs and non-case revenues slightly offset by lower volumes. For Q4, Invisalign ASPs for comprehensive treatment were up sequentially and up year-over-year.

現在是我們第四季的財務業績。第四季總營收為 9.567 億美元，季減 0.4%，年增 6.1%。以固定匯率計算，23 年第 4 季營收受到不利外匯影響約 1,280 萬美元，即季增約 1.3%，年比受到不利影響約 1,380 萬美元，約 1.5%。對於透明對準器，第四季營收為 7.819 億美元，環比下降 1.6%，主要是由於銷量下降。與去年同期相比，第四季透明矯正器收入成長了 6.9%，主要是由於平均售價上升和非病例收入被銷量下降略微抵消。第四季度，Invisalign 隱適美綜合治療的 ASP 較上季上升，較去年同期上升。

On a sequential basis, ASPs reflect higher additional aligners, partially offset by the unfavorable impact from foreign exchange, higher sales credits and higher discounts. On a year-over-year basis, the increase in comprehensive ASPs reflect higher additional aligners, price increases and favorable impact from foreign exchange partially offset by higher discounts in product mix to lower ASP products. For Q4, ASPs for noncomprehensive treatment were down sequentially and up year-over-year. On a sequential basis, the decline in ASPs reflect the unfavorable impact from foreign exchange, a product mix shift to lower ASP products and higher net revenue deferrals, partially offset by price increases and lower discounts.

依序來看，平均售價反映了更高的額外調整，部分被外匯、更高的銷售信貸和更高的折扣的不利影響所抵消。與去年同期相比，綜合平均售價的成長反映了附加調整器的增加、價格上漲以及外匯帶來的有利影響，但部分被產品組合對較低平均售價產品的較高折扣所抵消。第四季度，非綜合治療的平均售價較上季下降，較去年同期上升。從環比來看，平均售價的下降反映了外匯的不利影響、產品組合轉向較低平均售價的產品以及較高的淨收入遞延，但部分被價格上漲和較低的折扣所抵消。

On a year-over-year basis, the increase in ASPs reflect price increases, the impact from favorable foreign exchange and higher additional aligners, partially offset by a product mix shift to lower ASP products and higher discounts.

與去年同期相比，平均售價的成長反映了價格上漲、有利外匯和更高附加調整的影響，但部分被產品組合轉向較低平均售價產品和較高折扣所抵消。

Last quarter, we announced about a 5% global price increase for some Invisalign products across most markets effective January 1, 2024. Invisalign Comprehensive Three and Three product is available in North America and certain markets in EMEA and APAC, most recently launching in China, Korea, Hong Kong and Taiwan. We are pleased with the continued adoption of the Invisalign Comprehensive Three and Three product and anticipate it will continue to increase, providing doctors the flexibility they want and allowing us to recognize more revenue upfront with deferred revenue being recognized over a shorter period compared to our traditional Invisalign comprehensive product.

上季度，我們宣布自2024 年1 月1 日起，部分Invisalign 隱適美產品的全球價格上漲約5%。Invisalign 綜合三號和三號產品在北美以及歐洲、中東和非洲和亞太地區的某些市場上市，最近在中國推出。韓國、香港、台灣。我們對隱適美綜合三號和三號產品的持續採用感到高興，並預計它將繼續增加，為醫生提供他們想要的靈活性，並使我們能夠預先確認更多的收入，與我們的傳統技術相比，遞延收入在更短的時間內確認Invisalign 隱適美綜合產品。

Q4 '23 Clear Aligner revenues were impacted by unfavorable foreign exchange of approximately $10.7 million or approximately 1.4% sequentially. On a year-over-year basis, Clear Aligner revenues were favorably impacted by foreign exchange of approximately $12 million or approximately 1.6%. Clear Aligner deferred revenues on the balance sheet increased $14.9 million or 1.2% sequentially and $74.6 million or up 6.1% year-over-year and will be recognized as the additional aligners are shipped.

23 年第 4 季 Clear Aligner 營收受到不利外匯影響約 1,070 萬美元，即季約 1.4%。與去年同期相比，Clear Aligner 的營收受到外匯的有利影響，約 1,200 萬美元，約 1.6%。資產負債表上的 Clear Aligner 遞延收入環比增長 1,490 萬美元，即 1.2%，同比增長 7,460 萬美元，即增長 6.1%，並將在額外的矯正器發貨時予以確認。

Q4 '23 Systems and Services revenues of $174.8 million were up 5.8% sequentially primarily due to higher ASPs and an increase in CAD/CAM and services revenue, partially offset by lower volumes and were up 2.9% year-over-year, primarily due to higher services revenues from our larger base of scanners sold and increased nonsystem revenues related to our CPO and leasing rental programs mostly offset by lower ASPs and scanner volume.

23 年第 4 季系統和服務收入為 1.748 億美元，環比增長 5.8%，主要是由於 ASP 上升以及 CAD/CAM 和服務收入增加，部分被銷量下降所抵消，同比增長 2.9%，主要是由於我們銷售的掃描儀基數較大，因此服務收入增加，而與我們的CPO 和租賃項目相關的非系統收入增加，大部分被平均售價和掃描儀銷量下降所抵消。

CAD/CAM and services revenues for Q4 represent approximately 50% of our Systems and Services business. Q4 '23 Systems and Services revenues were unfavorably impacted by foreign exchange of approximately $2.1 million or approximately 1.2% sequential. On a year-over-year basis, Systems and Services revenue were favorably impacted by foreign exchange of approximately $1.9 million or approximately 1.1%. Systems and Services deferred revenues on the balance sheet were down $4.3 million or 1.6% sequentially and down $13.1 million or 4.8% year-over-year, primarily due to the recognition of services revenue which is recognized ratably over the service period. As our scanner portfolio expands and we introduce new products, we increased the opportunities for customers to upgrade, make trade-ins and purchase certified preowned scanners in certain markets. Developing new capital equipment opportunities to meet the digital transformation needs of our customers and DSO partners is a natural progression for our equipment business with a large and growing base of scanners sold.

第四季 CAD/CAM 和服務收入約占我們系統和服務業務的 50%。 23 年第 4 季系統和服務收入受到外匯影響約 210 萬美元，比上一季成長約 1.2%。與去年同期相比，系統和服務收入受到外匯影響約 190 萬美元或約 1.1%。資產負債表上的系統和服務遞延收入環比下降 430 萬美元或 1.6%，年減 1,310 萬美元或 4.8%，這主要是由於服務收入的確認是在服務期間按比例確認的。隨著我們的掃描器產品組合的擴大和新產品的推出，我們增加了客戶在某些市場升級、以舊換新和購買經過認證的二手掃描器的機會。開發新的資本設備機會來滿足我們的客戶和 DSO 合作夥伴的數位轉型需求是我們設備業務的自然發展，因為我們銷售的掃描器基礎龐大且不斷成長。

Moving on to gross margin. Fourth quarter overall gross margin was 70%, up 0.9 points sequentially and up 1.5 points year-over-year. Q4 non-GAAP gross margin was 70.5% up 0.9 points sequentially and up 1.2 points year-over-year. Overall, gross margin was unfavorably impacted by foreign exchange by approximately 0.4 points sequentially and favorably impacted by approximately 0.4 points on a year-over-year basis.

轉向毛利率。第四季整體毛利率為70%，季增0.9個百分點，年增1.5個百分點。第四季非 GAAP 毛利率為 70.5%，季增 0.9 個百分點，較去年同期上升 1.2 個百分點。整體而言，毛利率連續受到匯率不利影響約0.4個百分點，較去年同期受到約0.4個百分點的有利影響。

Clear Aligner gross margin for the fourth quarter was 71.1% up 0.4 points sequentially primarily due to lower manufacturing spend, partially offset by higher freight costs. Clear Aligner gross margin for the fourth quarter was up 0.3 points year-over-year, primarily due to higher ASPs and favorable foreign exchange, partially offset by higher manufacturing spend and freight costs.

Clear Aligner 第四季的毛利率為 71.1%，較上一季成長 0.4 個百分點，主要是由於製造支出下降，但部分被貨運成本上升所抵銷。 Clear Aligner 第四季的毛利率年增 0.3 個百分點，主要是由於平均售價上升和有利的外匯匯率，但部分被較高的製造支出和貨運成本所抵銷。

Systems and Services gross margin for the fourth quarter was 64.8%, up 3.8 points sequentially due to higher ASPs, partially offset by higher service and freight costs. Systems and Services gross margin for the fourth quarter was up 6 points year-over-year due to improved manufacturing efficiencies and favorable foreign exchange, partially offset by lower ASPs.

由於平均售價上升，第四季系統和服務毛利率為 64.8%，比上一季成長 3.8 個百分點，但部分被服務和貨運成本上升所抵銷。由於製造效率提高和有利的外匯匯率，第四季度系統和服務毛利率年增 6 個百分點，但部分被平均售價下降所抵銷。

Before I go into the details, I want to note that during Q4 '23, we incurred a total of $14 million of restructuring and other charges, primarily related to post-employment benefits. Q4 operating expenses were $498 million, roughly flat sequentially and down 1.4 points year-over-year. On a sequential basis, operating expenses were up slightly due -- primarily due to restructuring and other charges, offset by lower employee compensation. Year-over-year operating expenses decreased by $7.1 million primarily due to controlled spend on advertising and marketing as part of our efforts to proactively manage costs, partially offset by employee-related costs and slightly higher restructuring charges.

在詳細介紹之前，我想指出，在 23 年第 4 季度，我們總共產生了 1,400 萬美元的重組費用和其他費用，主要與離職後福利有關。第四季營運支出為 4.98 億美元，與上一季大致持平，年減 1.4 個百分點。環比來看，營運費用略有上升，主要是由於重組和其他費用，但被員工薪資下降所抵消。營運支出較去年同期減少 710 萬美元，主要是由於我們積極主動管理成本，控制了廣告和行銷支出，但部分被員工相關成本和略高的重組費用所抵消。

On a non-GAAP basis, excluding stock-based compensation, restructuring and other charges and amortization of acquired intangibles related to certain acquisitions, operating expenses were $446.7 million, down 2.5% sequentially and down 2.8% year-over-year.

以非公認會計準則計算，不包括股票薪酬、重組和其他費用以及與某些收購相關的無形資產攤銷，營運費用為 4.467 億美元，比上一季下降 2.5%，比去年同期下降 2.8%。

Our fourth quarter operating income of $171.5 million resulted in an operating margin of 17.9%, up 0.6 points sequentially and up 5.4 points year-over-year. Operating margin was unfavorably impacted by approximately 0.6 points sequentially primarily due to foreign exchange. The year-over-year increase in operating margin is primarily attributed to operating leverage and proactively managing our costs as well as favorable impact from foreign exchange by approximately 0.6 points.

第四季營業收入為 1.715 億美元，營業利潤率為 17.9%，季增 0.6 個百分點，較去年同期成長 5.4 個百分點。營業利潤率連續受到約 0.6 個百分點的不利影響，主要是由於外匯因素。營業利潤率年增主要歸功於營業槓桿和積極管理成本以及外匯的有利影響約0.6個百分點。

On a non-GAAP basis, which excludes stock-based compensation, restructuring and other charges, the amortization of intangibles related to certain acquisition, operating margin for the fourth quarter was 23.8%, up 2 points sequentially and up 5.5 points year-over-year.

以非公認會計準則（不包括股票薪酬、重組和其他費用）計算，與某些收購相關的無形資產攤銷，第四季度營業利潤率為23.8%，環比增長2 個百分點，同比增長5.5 個百分點。年。

Interest and other income and expense net for the fourth quarter was an income of $1.3 million compared to a loss of $4.2 million in the third quarter and income of $2.7 million in Q4 2022, primarily driven by favorable foreign exchange. The GAAP effective tax rate for the fourth quarter was 28.3%, higher than the third quarter effective tax rate of 25.1% and lower than the fourth quarter effective tax rate of 63.8% in the prior year. The fourth quarter GAAP effective tax rate was higher than the third quarter effective tax rate primarily due to onetime benefit related to tax guidance issued in Q3, partially offset by lower U.S. taxes on foreign earnings in Q4.

第四季的利息及其他收入和支出淨額為130 萬美元的收入，而第三季的虧損為420 萬美元，2022 年第四季的收入為270 萬美元，這主要是由有利的外匯推動的。第四季公認會計原則有效稅率為28.3%，高於去年第三季25.1%的有效稅率，低於去年第四季63.8%的有效稅率。第四季 GAAP 有效稅率高於第三季有效稅率，主要是由於與第三季發布的稅收指引相關的一次性收益，部分被第四季美國海外所得稅降低所抵銷。

As a reminder, in Q4 2022, we changed our methodology for the computation of our non-GAAP effective tax rate to a long-term projected tax rate and have given effect to the new methodology from January 1, 2022. Our non-GAAP effective tax rate for the fourth quarter was 20%, reflecting the change in our methodology.

提醒一下，在 2022 年第四季度，我們將非 GAAP 有效稅率的計算方法更改為長期預計稅率，並從 2022 年 1 月 1 日起實施新方法。我們的非 GAAP 有效稅率第四季度的稅率為20%，反映了我們方法論的變化。

Fourth quarter net income per share was $1.64, up sequentially $0.06 and up $1.10 compared to the prior year. Our EPS was unfavorably impacted by $0.07 on a sequential basis and favorably impacted by $0.08 on a year-over-year basis due to foreign exchange. On a non-GAAP basis, net income per diluted share was $2.42 for the fourth quarter up $0.28 sequentially and up $0.69 year-over-year.

第四季每股淨利潤為 1.64 美元，比上一季增長 0.06 美元，比去年同期增長 1.10 美元。由於外匯影響，我們的每股盈餘環比受到 0.07 美元的不利影響，年比受到 0.08 美元的有利影響。以非公認會計準則計算，第四季攤薄後每股淨利潤為 2.42 美元，比上一季成長 0.28 美元，比去年同期成長 0.69 美元。

Moving on to the balance sheet. As of December 31, 2023, cash, cash equivalents and short and long term marketable securities were $980.8 million, down sequentially $321.2 million and down $60.8 million year-over-year. Of our $980.8 million balance, $196.1 million was held in the U.S. and $784.7 million was held by our international entities. In October 2023, we purchased approximately 1 million shares of our common stock at an average price of $190.56 per share through a $250 million Accelerated Share Repurchase. And in November and December 2023, we purchased approximately 466,000 shares of our common stock at an average price of $214.81 per share through a $100 million open market purchase, both under Align's current $1 billion stock repurchase program. We have $650 million remaining available for repurchase of our common stock under this stock repurchase program.

繼續看資產負債表。截至 2023 年 12 月 31 日，現金、現金等價物以及短期和長期有價證券為 9.808 億美元，比上一季減少 3.212 億美元，年減 6,080 萬美元。在我們的 9.808 億美元餘額中，1.961 億美元由我們的國際實體持有，7.847 億美元由我們的國際實體持有。 2023 年 10 月，我們透過 2.5 億美元的加速股票回購，以每股 190.56 美元的平均價格購買了約 100 萬股普通股。 2023 年11 月和12 月，我們透過1 億美元的公開市場購買，以每股214.81 美元的平均價格購買了約466,000 股普通股，這兩項交易均根據Align 目前10 億美元的股票回購計劃進行。根據該股票回購計劃，我們還有 6.5 億美元可用於回購普通股。

Q4 accounts receivable balance was $903.4 million, slightly down sequentially. Our overall days sales outstanding was 85 days, flat sequentially and year-over-year. Cash flow from operations for the fourth quarter was $46.9 million. Capital expenditures for the fourth quarter were $33.4 million, primarily related to our continued investments to increase aligner manufacturing capacity in facilities. Free cash flow, defined as cash flow from operations less capital expenditures, amounted to $13.5 million.

第四季應收帳款餘額為 9.034 億美元，季減。我們的總銷售天數為 85 天，環比和同比持平。第四季營運現金流為 4,690 萬美元。第四季的資本支出為 3,340 萬美元，主要與我們為提高對準器設施製造能力而持續進行的投資有關。自由現金流（定義為營運現金流減去資本支出）為 1,350 萬美元。

Now turning to our outlook. Assuming no circumstances occur beyond our control, we provide the following framework for Q1 and fiscal 2024. For Q1 2024, we expect our worldwide revenues to be in the range of $960 million to $980 million, up slightly from Q4 of 2023. We expect Clear Aligner volume and ASPs to be up slightly sequentially. We expect Systems and Services revenue to be down slightly sequentially, although less than the historical seasonal decline, given the launch of the iTero Lumina for ortho workflows in Q1 2024.

現在轉向我們的展望。假設沒有發生我們無法控制的情況，我們為第一季和2024 財年提供以下框架。對於2024 年第一季度，我們預計我們的全球收入將在9.6 億美元至9.8 億美元之間，比2023 年第四季略有上升。我們預計明確對準器銷售和平均銷售價格將連續小幅上升。鑑於 2024 年第一季推出用於正交工作流程的 iTero Lumina，我們預計系統和服務收入將環比略有下降，儘管低於歷史季節性下降幅度。

We expect our Q1 2024 GAAP operating margin and non-GAAP operating margin to be slightly above Q1 2023 GAAP operating margin and non-GAAP operating margin, respectively. For full year, we expect fiscal 2024 total revenues to be up mid-single digits over 2023. We expect fiscal 2024 Clear Aligner and Systems and Services revenues to grow year-over-year in the same approximate range as our 2024 total revenues. We expect fiscal 2024 Clear Aligner ASPs to be up slightly year-over-year primarily due to price increases and favorable foreign exchange, partially offset by a higher mix of noncomprehensive products, which have lower ASPs. We expect fiscal 2024 GAAP operating margin and non-GAAP operating margin to be slightly above the 2023 GAAP operating margin and non-GAAP operating margin, respectively. We expect our investments in capital expenditures for the fiscal 2024 to be approximately $100 million. Capital expenditures are expected to primarily relate to building construction and improvements as well as manufacturing capacity in support of our continued expansion.

我們預計 2024 年第一季 GAAP 營業利潤率和非 GAAP 營業利潤率將分別略高於 2023 年第一季 GAAP 營業利潤率和非 GAAP 營業利潤率。就全年而言，我們預計2024 財年的總收入將比2023 年增長中個位數。我們預計2024 財年透明對準器以及系統和服務收入的同比增長範圍將與2024 年總收入大致相同。我們預計 2024 財年透明矯正器的平均售價將同比小幅上漲，主要是由於價格上漲和有利的外匯，但部分被平均售價較低的非綜合產品組合的增加所抵消。我們預計 2024 財年 GAAP 營業利潤率和非 GAAP 營業利潤率將分別略高於 2023 財年 GAAP 營業利潤率和非 GAAP 營業利潤率。我們預計 2024 財年的資本支出投資約為 1 億美元。資本支出預計主要涉及建築施工和改進以及製造能力，以支持我們的持續擴張。

In summary, I am pleased with our fourth quarter and fiscal 2023 results, and I am especially proud of our continued focused execution of our product road map and innovation pipeline. We are committed to delivering on our strategic growth drivers of international expansion, patient demand, orthodontist utilization and GP dentist treatment to extend our leadership in digital orthodontics and dentistry. I believe that the next wave of innovation that we are introducing into the market will further differentiate Align and allow us to continue to increase our share of the large untapped market opportunity of 22 million annual orthodontic case starts as well as an additional 600 million consumers who could benefit from a healthy, beautiful smile using Invisalign Clear Aligners.

總而言之，我對我們第四季和 2023 財年的業績感到滿意，我對我們持續專注於執行我們的產品路線圖和創新管道感到特別自豪。我們致力於實現國際擴張、患者需求、正畸醫生利用和全科醫生牙醫治療等策略性成長動力，以擴大我們在數位正畸和牙科領域的領導地位。我相信，我們引入市場的下一波創新將進一步使 Align 脫穎而出，並使我們能夠繼續增加在每年 2200 萬個正畸病例啟動以及另外 6 億消費者的巨大未開發市場機會中的份額。使用Invisalign隱適美隱形矯正器，您可以從健康、美麗的笑容中受益。

With that, I'll turn it back to Joe for final comments. Joe?

這樣，我會將其轉回給喬以徵求最終意見。喬？

Thanks, John.

謝謝，約翰。

In closing, while I'm pleased with our better-than-expected fourth quarter results and start to the year, I'm even more excited about Align innovation in 2024 and our next wave of growth drivers.

最後，雖然我對我們好於預期的第四季業績和年初業績感到滿意，但我對 2024 年的 Align 創新和我們的下一波成長動力感到更加興奮。

When I spoke to you about a year ago, I discussed the innovations that we are planning to bring to market that we continue to revolutionize the orthodontic and dental industry and scanning software and direct 3D printing. We are delivering on that promise. With the introduction of iTero Lumina powered by Multi-Direct Capture technology, we are pushing the boundaries of what inter-oral scanners can do. iTero Lumina is a combination of years of research and development to offer visualization capabilities that support doctors, clinical decisions while also enhancing their patients' comfort and overall treatment experiences. Building on more than 20 years of expertise in revolutionizing imaging technologies, the iTero Lumina scanner elevates the standard in digital scanning to achieve exceptional clinical outcomes and increased practice efficiency. The iTero scanner is at the forefront of digital dentistry.

大約一年前，當我與您交談時，我討論了我們計劃推向市場的創新，我們將繼續徹底改變正畸和牙科行業以及掃描軟體和直接 3D 列印。我們正在兌現這項承諾。隨著採用多直接擷取技術的 iTero Lumina 的推出，我們正在突破口內掃描器的功能界限。 iTero Lumina 結合了多年的研究和開發，提供視覺化功能，支援醫生和臨床決策，同時提高患者的舒適度和整體治療體驗。 iTero Lumina 掃描儀以 20 多年革新影像技術的專業知識為基礎，提升了數位掃描的標準，以實現卓越的臨床結果並提高實踐效率。 iTero 掃描儀處於數位牙科的前沿。

With the closing of our acquisition of Cubicure, a pioneer of direct 3D printing solutions for polymer additive manufacturing, we will enable the next generation of 3D printed products, helping to create more unique configurations for aligners that are more sustainable and also efficient solutions. We also expect it to extend and scale our printing materials and manufacturing capabilities for our 3D printed product portfolio, which now includes the Invisalign Palate Expander System. And with the introduction of IPE, we have expanded the clinical applicability of the Invisalign system to nearly 100% of the orthodontic case starts. The ability to direct 3D print, IPE will eventually lead to other direct printed products with the goal of direct 3D printed Invisalign Clear Aligners, which we hope to achieve in the next couple of years.

隨著我們對聚合物增材製造直接3D 列印解決方案先驅Cubicure 的收購完成，我們將實現下一代3D 列印產品，幫助為矯正器創建更獨特的配置，這些配置是更可持續、更有效率的解決方案。我們還期望它能夠擴展和擴展我們 3D 列印產品組合的列印材料和製造能力，其中現在包括 Invisalign 腭擴張器系統。隨著 IPE 的推出，我們將 Invisalign 隱適美系統的臨床適用性擴展到近 100% 的矯正病例。 IPE 的直接 3D 列印能力最終將導致其他直接列印產品的出現，其目標是直接 3D 列印 Invisalign 隱形矯正器，我們希望在未來幾年內實現這一目標。

As a company, Align has multifaceted competitive advantage, technology innovation, where we invest up to $300 million in R&D per year to bring in some of the most disruptive products in digital dentistry and orthodontics to the market in a highly regulated industry. A direct sales force that consists of 5,000 highly trained specialists, a doctor-centered model because we understand the importance of doctor-directed care, a $1 billion brand trusted by over 17 million patients worldwide and global scale and manufacturing to deliver millions of customized Clear Aligner parts every day. We are extremely pleased with our latest innovations and commercialization of products to better serve our doctors, customers and their patients. Our belief in the future business overall is unwavering.

作為一家公司，Align 擁有多方面的競爭優勢和技術創新，我們每年投資高達 3 億美元的研發資金，將數位牙科和矯正領域一些最具顛覆性的產品推向高度監管行業的市場。由5,000 名訓練有素的專家組成的直銷隊伍，以醫生為中心的模式，因為我們了解醫生指導護理的重要性，這是一個價值10 億美元的品牌，受到全球超過1700 萬患者的信賴，其全球規模和製造能力可提供數以百萬計的客製化透明產品每天對準器零件。我們對產品的最新創新和商業化感到非常滿意，以便更好地服務我們的醫生、客戶及其患者。我們對未來業務的整體信心堅定不移。

Before we turn the call over to the operator, I want to address an important matter regarding DTC or direct to consumer Clear Aligners in our industry. Align has always believed that a doctor-centered model for orthodontic treatment is the safest for patients, and we're always looking for new and better ways to support doctors as they work to create better smiles for their patients.

在我們將電話轉交給營運商之前，我想解決一個有關 DTC 或直接面向我們行業消費者的透明對準器的重要問題。 Align 始終相信，以醫生為中心的矯正治療模式對患者來說是最安全的，我們一直在尋找新的、更好的方法來支持醫生努力為患者創造更好的笑容。

Recent news regarding the bankruptcy of a DTC clear aligner company has led many consumers to reach out to Invisalign providers to address their unmet needs, including helping those DTC patients with incomplete treatments. To support these former DTC patients who are seeking help from Invisalign providers and practices, in Q4 we introduced a program in the U.S. and select other markets, offering up to a 50% off Invisalign case submission in Vivera Retention to help offset any additional cost to finish their treatment. We want to help everyone achieve a healthy beautiful smile and strongly recommend that individuals who are impacted by this matter seek the advice of a licensed orthodontist or dentist. Our concierge team is always available to answer questions and help connect consumers with Invisalign practices.

最近有關 DTC 透明矯正器公司破產的消息促使許多消費者向 Invisalign 隱適美提供者尋求幫助，以解決他們未滿足的需求，包括幫助那些治療不完整的 DTC 患者。為了支持這些向Invisalign 隱適美提供者和診所尋求幫助的前DTC 患者，我們在第四季度在美國和選定的其他市場推出了一項計劃，在Vivera Retention 中提供高達50% 的Invisalign 隱適美病例提交折扣，以幫助抵消任何額外費用完成他們的治療。我們希望幫助每個人獲得健康美麗的微笑，並強烈建議受此問題影響的個人尋求有執照的正畸醫生或牙醫的建議。我們的禮賓團隊隨時為您解答問題並協助消費者了解 Invisalign 隱適美療程。

With that, I'll thank you for your time today. We look forward to updating you on our next earnings call. Now I'll turn the call over to the operator for questions. Operator?

至此，我要感謝您今天抽出時間。我們期待在下次財報電話會議上向您通報最新情況。現在我將把電話轉給接線員詢問問題。操作員？

(Operator Instructions) Our first question comes from Elizabeth Anderson with Evercore ISI.

（操作員說明）我們的第一個問題來自 Evercore ISI 的 Elizabeth Anderson。

Congrats on the quarter. I was wondering if you could walk us through the components of the mid-single-digit guide. I got -- for 2024. I understand what you said that like Systems and Services and Clear Aligners would be in the same range. I guess I'm just sort of thinking about like how to think about that. It seems like maybe it's like low single-digit ASP improvement and then sort of low to mid-single-digit case growth. Is that the right way to think about it? Like what else can you -- is there anything else you can sort of clarify on that? And sort of how do you expect at least currently, the sort of pacing of the year to progress.

恭喜本季。我想知道您是否可以向我們介紹中個位數指南的組成部分。我得到了 - 2024 年。我理解您所說的，像系統和服務以及透明對準器將在同一範圍內。我想我只是在思考如何思考這個問題。看起來可能是低個位數的平均售價改善，然後是低到中個位數的病例成長。這是正確的思考方式嗎？你還能做什麼－對此你還有什麼可以澄清的嗎？至少目前你預計今年的進展節奏是怎麼樣的。

Yes. Elizabeth, this is John. You haven't framed the right way. We're looking at the segments up mid-single digits and then ASPs because of the price increase. We have some offset due to some of the lower-stage products that we have, including the DSP touch-ups and so on, that you would expect then a little bit lower of ASP impact year-over-year.

是的。伊麗莎白，這是約翰。你沒有以正確的方式建構。由於價格上漲，我們正在關注這些細分市場的中個位數成長，然後是平均售價。由於我們擁有一些較低階段的產品，包括 DSP 修飾等，我們有一些抵消，您預計 ASP 的影響會比去年同期稍低一些。

Got it. That makes sense. And then separately, how has the volume in sort of market in China been progressing across the fourth quarter and maybe into the first quarter so far as you can comment.

知道了。這就說得通了。另外，據您評論，第四季甚至第一季中國市場的交易量進展如何。

Elizabeth, it's Joe. We felt good about China last year. But remember, we had year-over-year comparisons that were really favorable because of the COVID shuts down over there last year. But overall, as we exited the year, we felt good about our performance there, and we feel good about as we move into 2024 about our competitive position there in -- a China market that I think is a little more predictable because it's not the overhead that we've seen with COVID over the last, really, several years.

伊莉莎白，是喬。去年我們對中國感覺很好。但請記住，我們進行了逐年比較，結果非常有利，因為去年那裡因新冠疫情而關閉。但總的來說，當我們結束這一年時，我們對我們在那裡的表現感到滿意，當我們進入2024 年時，我們對我們在中國市場的競爭地位感到滿意——我認為中國市場更容易預測，因為它不是過去幾年我們在新冠疫情中看到的開銷。

Got it. And sorry, maybe one last one for me. Can you just remind us the sort of 1Q dip in the operating margins and then how it sort of steps up across the year. I understand the guidance you gave for the first quarter of the year, but just why that first quarter has a sort of different perspective than the rest of the year?

知道了。抱歉，也許是我的最後一件事。您能否提醒我們第一季營業利潤率下降，然後全年營業利潤率如何上升。我理解您為今年第一季提供的指導，但為什麼第一季的觀點與今年剩餘時間有所不同？

Yes. So we wanted to give to prior year because in that prior year, when you start the year, you have certain expenses that you incur right at the beginning, payroll, taxes and other things that you incur initially some of the investments that you make that you then get leverage on as you go through the year. So it's similar to how we position things from last year in 2023.

是的。所以我們想把錢捐給前一年，因為在前一年，當你開始這一年時，你會在年初產生某些費用，工資，稅收和其他你最初產生的一些投資然後你就會在這一年中獲得槓桿作用。所以這與我們去年對 20​​23 年的定位類似。

Our next question comes from Jeff Johnson with Baird.

我們的下一個問題來自 Jeff Johnson 和 Baird。

Can you hear me out there?

你能在外面聽我說話嗎？

Yes. We hear you fine.

是的。我們聽到你的聲音很好。

John, maybe I want to -- I'll follow up on Elizabeth's margin question there beyond just the 1Q. Let's say, you hit your guidance this year on operating margin is up nominally from 2023 level. It'd be 3 years in a row kind of in that low to mid-21% range. I think pre-COVID you were up in the 25% range or so. What's it going to take to get those margins moving back towards those pre-COVID. You've taken price increases 2 years in a row. It feels like your R&D should be coming down a little bit. Obviously, with Cubicure and that, I know you're continuing to invest aggressively, but IPE is out, Lumina now out, things like that. So just help us understand when could we start to see a path back towards getting those margins maybe up a few points from where they've settled in the last few years?

約翰，也許我想——我會在第一季之外跟進伊麗莎白的保證金問題。假設，您今年的營業利潤率名義上高於 2023 年的水平，達到了預期目標。這將是連續 3 年處於 21% 的中低範圍。我認為在新冠疫情爆發之前，漲幅在 25% 左右。怎麼樣才能讓這些利潤率回到新冠疫情之前的水準呢？您已連續兩年漲價。感覺你的研發應該要下降一點。顯然，有了 Cubicure 之類的產品，我知道你們會繼續積極投資，但 IPE 已經退出，Lumina 已經退出，諸如此類。因此，請幫助我們了解什麼時候我們才能開始看到一條回升之路，使這些利潤率可能比過去幾年的水平提高幾個百分點？

Yes, Jeff, this is John. Really, when you start to get some of that volume leverage, we're positioned as having our manufacturing and the organization that we have that's really set to drive more growth. And once we get some of that volume leverage, we should see that benefit showing up in our numbers. And it's really what we saw as we went through the quarters last year where you see some of that volume benefit. You get that benefit as well when you go through the year, but really looking to try to drive as much volume as we can and you'll start to see some of that leverage that shows up in our numbers.

是的，傑夫，這是約翰。事實上，當你開始獲得一些銷售槓桿時，我們的定位是擁有真正能夠推動更多成長的製造和組織。一旦我們獲得了一定的銷售槓桿，我們應該會看到這種好處出現在我們的數據中。這確實是我們去年幾季所看到的，你看到了一些銷售收益。當你度過這一年時，你也會得到這種好處，但真正希望嘗試盡可能地推動銷量，你會開始看到我們的數字中出現的一些槓桿作用。

All right. Fair enough. And then, Joe, I think we've talked for many years now how iTero is carved out such a commanding, strong competitive position. You've sold a ton of iTeros over the last 5, 6 years or so. They're all probably getting, I don't know, close to their end of their useful life or so. Lumina for the first time feels like that kind of product with a better form factor, especially things like that, that could really cause some of these docs to say, I got to get rid of this big iTero and go back down to this much smaller one, and things like that, just things that would actually matter to the docs, and I'm sure the technology does this, too, I don't want to just put it on the size. But just thinking there, is this the kind of product that can finally kick off that multiyear upgrade strategy or path in iTero that we've kind of been waiting to see?

好的。很公平。然後，喬，我想我們已經討論了很多年了，iTero 是如何佔據如此主導地位的、強大的競爭地位的。在過去 5、6 年左右的時間裡，您已經售出了大量 iTeros。我不知道，它們可能都已經接近使用壽命了。 Lumina 第一次感覺像是那種具有更好外形的產品，尤其是類似的東西，這可能真的會讓一些文件說，我必須擺脫這個大 iTero，回到這個小得多的產品一，諸如此類的事情，只是對文件真正重要的事情，我確信技術也能做到這一點，我不想只把它放在尺寸上。但想想看，這種產品是否能夠最終啟動我們一直在等待看到的 iTero 多年升級策略或路徑？

Jeff, the easy answer and the quick answer is yes. I mean it's just a brand-new platform. Now we set up -- I mentioned in my script about we have 100,000 units out there that we've sold so far. About 1/3 of those are 5D pluses, which are upgradable by just wand switch out. This is the way we've designed Lumina. And so that part's easy. Also, we've been really aggressively upgrading our installed base between E1 and E2 out there too to better position it for this kind of a move. So as we develop Lumina, we had exactly in mind what you just questioned, and we think we're in a good position to do that.

傑夫，簡單且快速的答案是肯定的。我的意思是這只是一個全新的平台。現在我們已經準備好了——我在劇本中提到，到目前為止我們已經售出了 100,000 件。其中約 1/3 是 5D plus，只需切換魔杖即可升級。這就是我們設計 Lumina 的方式。所以這部分很簡單。此外，我們也一直在積極升級 E1 和 E2 之間的安裝基礎，以便更好地適應這種遷移。因此，當我們開發 Lumina 時，我們確實考慮到了您剛才提出的問題，並且我們認為我們有能力做到這一點。

And if you switch out that wand from the 5 to the Lumina, there is a fee there, right? It's not like, hey, you bought this knowing that you could always upgrade at no charge to Lumina?

如果你把魔杖從 5 換成 Lumina，就要付費，對吧？這並不是說，嘿，您購買此產品時知道自己可以隨時免費升級到 Lumina？

There's no charity here at Align. There will be a charge.

Align 這裡沒有慈善機構。那是要收費的。

I like to hear that. God bless capitalism.

我喜歡聽這個。上帝保佑資本主義。

Our next question comes from Jon Block with Stifel.

我們的下一個問題來自 Jon Block 和 Stifel。

So Joe, maybe this one's for you. Video 1Q '24 IPE some markets today, but more in the common IPE should have longer term with team, docs might take a little bit of a wait-and-see approach. You talked about the new scanner. In your opinion, like is innovation are we seeing that in the '24 guide? Or is that more of like a ramp in the '25? And maybe even to take that a step further, John, for you, is there a way to sort of quantify out of that mid-single-digit revenue growth, what can you attribute to these new products coming on board in '24? I'm just trying to think about the impact of '24, is this more the ramp or the slope in the '25 for the innovation hitting?

所以喬，也許這個適合你。影片 24 年第 1 季 IPE 今天在一些市場上推出，但更多的是常見的 IPE 應該與團隊有更長期的合作，文件可能會採取一點觀望的態度。你談到了新的掃描器。您認為，我們在「24 小時指南」中是否看到了創新？還是這更像是 25 世紀的坡道？也許更進一步，約翰，對你來說，有沒有一種方法可以量化中個位數的收入成長，你可以將 24 年推出的這些新產品歸因於什麼？我只是想思考 24 年的影響，這更像是 25 年創新衝擊的斜坡還是斜坡？

Jon, I like the way you set that up. It's a ramp, it really is. But we feel good that we can play offense with these product lines. Now we still have to scale IPE. We have a great team that knows how to scale, and we'll get through that. Obviously, Lumina is a completely different set of outside of the computer itself. The wand itself is we feel good about the scale part of that as we sell through the marketplace. But overall, I think the way you described it is a ramp of this new technology really beginning in 2024 is a good foundation for that kind of thought process.

喬恩，我喜歡你的設定方式。這是一個坡道，確實如此。但我們很高興能夠利用這些產品線發動攻擊。現在我們仍然需要擴大 IPE 的規模。我們擁有一支優秀的團隊，知道如何擴大規模，我們會度過難關。顯然，Lumina 是電腦本身之外的一套完全不同的系統。魔杖本身是我們在市場上銷售時對其規模部分感覺良好的部分。但總的來說，我認為你描述的這種新技術從 2024 年真正開始的斜坡是這種思考過程的良好基礎。

And any way to quantify what's in there from the current guide or no? Is that just too difficult to tease out?

有什麼方法可以量化目前指南中的內容或沒有嗎？是不是太難弄清楚了？

It really is just too...

實在是太...

Okay. Okay. So second one is maybe a multipart. But just first on the CapEx, $100 million. I mean I was really surprised on how low that number was for this year. It's $400 million in '21, $300 million in '22 million, and I was maybe even more surprised when I think about the direct fabrication initiatives. So I know the slides say hoping to print Invisalign Clear Aligner "next couple of years". Do we still think retainers 2H '24, 1H '25? When do we feel like you proved it out, so to say? And do we start to see gross margin benefits from this as early as next year, turning accretive in 2025. And then admittedly just a jump to another question. For the guidance, can you just help us what's embedded in there? And I bring that up because we've seen this big move in U.S. consumer confidence. Europe still seems very choppy. So when we tie back to your guidance for the year, what are you extrapolating out, if you would, for the current macro?

好的。好的。所以第二個可能是多部分的。但首先是資本支出，1 億美元。我的意思是，我對今年這個數字如此之低感到非常驚訝。 21 年是 4 億美元，2,200 萬美元是 3 億美元，當我想到直接製造計畫時，我可能會更加驚訝。所以我知道幻燈片上說希望「未來幾年」列印 Invisalign 隱形矯正器。我們也認為保留人 2H '24、1H '25 嗎？可以這麼說，我們什麼時候覺得你證明了這一點？我們是否最早會在明年開始看到毛利率從中受益，並在 2025 年開始增加。然後無可否認，這只是跳到另一個問題。作為指導，您能幫助我們了解其中嵌入的內容嗎？我提出這個問題是因為我們看到美國消費者信心發生了重大變化。歐洲似乎仍然很不穩定。因此，當我們聯繫您今年的指導時，如果您願意的話，您對當前的宏觀經濟有何推論？

I'll start with that, Jon, in terms of the current guidance. Look, we're looking at the environment that we're all in. It's not a great economy, most places, but it is more stable, and we're building off of that. And then as Joe said, we're doing things to play offense. New products that we have with Lumina and IPE and so on, which we think, can help us grow in this environment.

喬恩，我將從目前的指導開始。看，我們正在關注我們所處的環境。大多數地方的經濟狀況並不是很好，但它更加穩定，我們正在以此為基礎進行建設。然後正如喬所說，我們正在做一些事情來進攻。我們認為，我們的 Lumina 和 IPE 等新產品可以幫助我們在這種環境中成長。

Jon, your question about the ramp up, the margin piece or part of that, what's that mean in 2025 or whatever. Look, we feel confident, and as you know from our discussions and our analyst presentation last year is 3D printing is foundationally, it can be less expensive as we scale. And so I mean, we'll start to see that come through as we scale that. But we need time to scale this. No one's ever had this polymer before that has a scale. No one's ever used the Cubicure system to the degree that we need to use it. Now we did this with 3D systems years ago because we basically scaled those systems through our team and team knows how to do that. I just can't tell you specifically within those in the next 1 to 3 years, with this being the first year, exactly when that really hits that hyperbolic side.

Jon，你的問題是關於成長、利潤部分或其中的一部分，這在 2025 年或其他什麼時候意味著什麼。看，我們充滿信心，正如您從我們去年的討論和分析師演講中了解到的那樣，3D 列印從根本上來說是基礎，隨著我們規模的擴大，它的成本可能會更低。所以我的意思是，當我們擴大規模時，我們將開始看到這一點。但我們需要時間來擴大規模。在此之前沒有人擁有過這種具有規模的聚合物。從來沒有人使用過 Cubicure 系統到我們需要使用它的程度。現在我們幾年前就用 3D 系統做到了這一點，因為我們基本上透過我們的團隊擴展了這些系統，而團隊知道如何做到這一點。我只是無法具體告訴你未來 1 到 3 年內的情況，今年是第一年，具體何時真正達到雙曲線。

And just to close on the CapEx, those prior years, that was -- a lot of that was -- it was equipment. Of course, we are always adding capacity, but a lot of that was very much unique for buildings, adding buildings for our locations, manufacturing and so on. And when we add some of the capacity that we're adding for our manufacturing, it will go in existing buildings. So we don't have to add another building in most cases for this. So that's why the CapEx is where it is.

就資本支出而言，前幾年，其中許多是設備。當然，我們一直在增加產能，但其中許多對於建築來說都是非常獨特的，為我們的地點、製造等增加建築。當我們增加一些為製造而增加的產能時，它將進入現有的建築物。因此，在大多數情況下，我們不必為此添加另一棟建築物。這就是資本支出的原因。

Our next question comes from Brandon Vazquez with William Blair.

我們的下一個問題來自布蘭登·巴斯克斯和威廉·布萊爾。

On the guidance, maybe one other way I wanted to ask you and see if I could tease out a little bit of color on what's assumed here. If I kind of go back to some old sequentials in the teen side, assuming that's a little less susceptible to macro headwinds, you can probably kind of get to a low single-digit volume growth, I think, for the entire Clear Aligner business already, but probably not even including some DSP. So is that -- am I thinking about this correctly that really out of adults on a year-over-year basis for full year '24, you're really assuming kind of flattish, maybe even down depending on how teens and some of the DSP cases are doing?

關於指導，也許我想以另一種方式問你，看看我是否可以對這裡的假設梳理出一點顏色。如果我回到青少年方面的一些舊序列，假設這不太容易受到宏觀逆風的影響，我認為整個透明對準器業務可能會達到低個位數的銷量增長，但可能甚至不包括一些 DSP。那麼，我是否正確地考慮了這一點，在 24 年全年的基礎上，成年人確實是在假設某種平坦的，甚至可能是下降的，這取決於青少年和一些人的表現DSP案例是做什麼的？

I would characterize it, Brandon, this is John, that both teen and adult are positive on a year-over-year basis, expect maybe adults to grow faster as we've seen compared to -- teens grow faster than adults as we've seen in the past, but I would expect both of them to be up and show our numbers that way.

我會描述這一點，布蘭登，這是約翰，青少年和成人在逐年的基礎上都是積極的，預計成年人可能會成長得更快，正如我們所看到的——青少年比成年人成長得更快。我們過去見過，但我希望他們都能以這種方式展示我們的數據。

Okay. And then can you just reiterate maybe both for IPE and for Lumina exciting. It seems like they're going to ramp over the coming quarters. Are there any like key quarters and catalysts that we should think about that might take that up. You're talking about a ramp, but we get to the next level on the ramp on any of those when they go from maybe a limited launch to full market relief, anything like that?

好的。然後您能否重申一下，也許 IPE 和 Lumina 都令人興奮。看起來他們將在接下來的幾季加速發展。我們是否應該考慮任何類似的關鍵季度和催化劑可能會解決這個問題。你說的是斜坡，但當它們從有限的推出到全面的市場緩解時，我們就進入了斜坡的下一個水平，類似的事情嗎？

Brandon, Joe again. On the Lumina side, remember, our restorative scanner for GPs comes out in the third quarter. But as like John indicated, we indicated, we feel we can sell that into the market now with the capabilities it has, but that will ramp in -- that will probably be more hinged to the regulatory approvals we have to get around the world. Right now, as I mentioned, we only have the United States and Canada and ANZ. Secondly, on IPE, it's the same thing is we're regulatory constrained. We still have to go through Europe. And as I mentioned, IPE will come out in the second quarter in Australia and also. And as we gave that, obviously, we'll be scaling IPE too and understanding the dynamics around that. So it's more of a ramp, as I mentioned a few calls ago than anything.

布蘭登，又是喬。在 Lumina 方面，請記住，我們的全科醫生恢復掃描器將於第三季推出。但正如約翰所指出的那樣，我們表示，我們認為我們現在可以以其擁有的功能將其出售到市場，但這將會逐漸增加 - 這可能更取決於我們必須在世界各地獲得的監管批准。正如我所提到的，目前我們只有美國、加拿大和澳新銀行。其次，在 IPE 上，同樣的事情是我們受到監管限制。我們還得經過歐洲。正如我所提到的，IPE 將於第二季在澳洲推出。正如我們所指出的，顯然我們也會擴展 IPE 並了解與之相關的動態。所以這更像是一個斜坡，正如我之前幾次電話中提到的那樣。

Our next question comes from Jason Bednar with Piper Sandler.

我們的下一個問題來自 Jason Bednar 和 Piper Sandler。

I'm going to pile on here on the guidance, just to focus there first. You mentioned noncomprehensive mix as being an offsetting factor to ASPs. I know you've got that DSP factor. I had thought maybe originally you were signaling adults growing better than teens, but doesn't seem like that's the case just given your comments there to Brandon. But I guess, regardless on adults, are you seeing this market getting its footing back, it sounds like it, but if you are, what's giving you the confidence? Or what are you seeing that kind of the day-to-day or month-to-month that's showing adults are coming back into the office for treatment. And then sorry to load a few in here, but should we expect this faster noncomprehensive mix also to have gross margin benefits for the year as well? I think it typically does, but I don't think we've gotten kind of a gross margin cadence outlook for '24.

我將在這裡堆砌指導，只是為了首先關注這一點。您提到不全面的混合是 ASP 的抵消因素。我知道你有 DSP 因素。我以為你最初可能是在暗示成年人比青少年成長得更好，但考慮到你對布蘭登的評論，情況似乎並非如此。但我想，無論對成年人來說，你是否看到這個市場正在重新站穩腳跟，聽起來是這樣，但如果你是，是什麼給了你信心？或您每天或每月看到什麼表明成年人正在回到辦公室接受治療。然後很抱歉在這裡加載一些內容，但是我們是否應該期望這種更快的非全面組合也能帶來今年的毛利率收益？我認為通常是這樣，但我認為我們還沒有得到 24 年毛利率的預期。

Jason, I'll take the first part of your question and hand the rest off to John, is we feel we're on a more stable, I'd call it, economic platform than last year. And so the adult and teen question that you had is we expect that to carry through in 2024, as we indicated with our guidance, too. So when I look back, everybody has a clear vision backwards than forward, we look back to last year, a pretty unstable platform that we experienced for the year and the third quarter was a tough one in that sense. But I think we all see it right now, we have more confidence that at least we're dealing with stability from an economic standpoint in most parts of the world from what we see.

傑森，我將回答你問題的第一部分，並將其餘部分交給約翰，我們是否覺得我們處於一個比去年更穩定的經濟平台上？因此，您提出的成人和青少年問題是，我們預計這種情況將在 2024 年實現，正如我們在指導中指出的那樣。因此，當我回顧過去時，每個人都有一個清晰的向後願景，而不是向前願景，我們回顧去年，我們這一年經歷了一個相當不穩定的平台，從這個意義上說，第三季度是一個艱難的平台。但我認為我們現在都看到了這一點，我們更有信心，至少從我們所看到的世界大部分地區的經濟角度來看，我們正在處理穩定問題。

And on the noncomprehensive and gross margin questions and related to that. Look, as we have the mix that shifts through and you might have an ASP lower on some of the non-comp DSP and others that fall into that. Those are our highest gross margin products from a rate standpoint. So they're helpful for us as a business. It's really what that customer wants for him or her to run their practice and that's how we balance things out. But overall, we expect that we would see benefits in gross margin just like we're talking about op margin year-over-year benefits, we should see a benefit as well in gross margin.

關於非全面和毛利率問題以及與之相關的問題。聽著，因為我們的組合會發生變化，因此某些非補償 DSP 和其他屬於該情況的 DSP 的 ASP 可能會較低。從費率的角度來看，這些是我們毛利率最高的產品。所以它們對我們的企業很有幫助。這確實是客戶希望他或她開展業務的方式，這就是我們平衡事物的方式。但總的來說，我們預計我們會看到毛利率的成長，就像我們談論營運利潤率同比增長一樣，我們也應該看到毛利率的成長。

All right. That's helpful. And then for the follow-up here, I'll ask on teens. It does look like you're back to gaining share against brackets and wires. It looks like the kind of the second consecutive quarter of that. I'm curious if you could talk maybe bigger picture, what's changed to what you think has changed over the last 3 to 6 months versus maybe the 12-plus months that preceded that. But do you think the share gains you're seeing versus brackets and wires, does that have to do with changes you made to that Teen Guarantee program middle part of last year? Or are there other items at the practice level or associated with your go-to-market activities that are driving that shift?

好的。這很有幫助。然後，對於這裡的後續行動，我將詢問青少年。看起來你確實又重新獲得了對抗支架和電線的份額。這看起來像是連續第二季出現的情況。我很好奇您能否談談更大的前景，您認為過去 3 到 6 個月與之前 12 個多月相比發生了哪些變化。但你認為你所看到的份額增長與括號和電線相比，這是否與你去年中期對青少年保障計劃所做的改變有關？或者實踐層面上或與您的上市活動相關的其他項目是否正在推動這種轉變？

You can always say that at Align, there's no single variable equations. And this is another one. The Teen Guarantee, we think is some of it, obviously, our portfolio and how we put that together, our DSP programs, the uniqueness of Invisalign First. All those things really help. And from an adult standpoint, with the firmer economic platform I talked about, I just think there's more confidence out there that we're starting to see lead through.

您總是可以說，在 Align 中，不存在單變數方程式。這是另一件事。我們認為青少年保證是其中的一部分，顯然，我們的產品組合以及我們如何將其組合在一起，我們的 DSP 項目，以及 Invisalign First 的獨特性。所有這些事情確實有幫助。從成年人的角度來看，隨著我談到的經濟平台更加堅定，我只是認為人們對我們開始看到領先地位有了更多信心。

Our next question comes from Michael Ryskin with Bank of America.

我們的下一個問題來自美國銀行的 Michael Ryskin。

I want to start with DSP kind of where you left off really successful, obviously, and you had great growth year-over-year for the whole year. But it's kind of moved in sort of like a step function. If I just look at the numbers, 6,000, 7,000, 9,000 and then you're kind of like an 11,000, 12,000 range. Now you're in the 18,000, 19,000, 20,000 range. Is there another step function coming next year? Is there -- could you dig into a little bit into what's driving that? And just sort of where do you see that going over the next couple of years?

我想從 DSP 開始，很明顯，您在這一方面非常成功，並且全年同比增長巨大。但它的移動有點像階躍函數。如果我只看數字，6,000、7,000、9,000，那麼範圍就有點像 11,000、12,000。現在您處於 18,000、19,000、20,000 範圍內。明年還會有另一個階梯功能嗎？您能深入研究一下是什麼推動了這個趨勢嗎？您認為未來幾年會發生什麼事？

Michael, this is John. I would say as we look to expand this out, it's been successful, every place that we've done, we've seen, as you said, North America starts with this. So you see some doctors start and then we have more and more doctors that sign up for the program. And then as the doctors sign up for the program, then they end up doing more and more volume with us. We've taken that same approach to other countries, and now we've introduced this in EMEA and other places. And the same thing happens. More and more doctors sign up for it. They start to see the benefits of it, and then they utilize it more. So it's really just a matter of now scaling this to other parts of the world because we find that this is really a nice way to supplement how a doctor wants to run their practice.

邁克爾，這是約翰。我想說，當我們尋求擴大這個範圍時，它是成功的，我們所做的每一個地方，我們都看到，正如你所說，北美就是從這個開始的。所以你會看到一些醫生開始，然後我們有越來越多的醫生報名參加該計劃。然後，當醫生報名參加該計劃時，他們最終會與我們一起做越來越多的治療量。我們對其他國家採取了同樣的方法，現在我們已在 EMEA 和其他地方引入了這種方法。同樣的事情也發生了。越來越多的醫生報名參加。他們開始看到它的好處，然後更多地利用它。因此，現在的問題實際上只是將其擴展到世界其他地區，因為我們發現這確實是補充醫生想要開展其實踐的方式的好方法。

Okay. And then maybe a follow-up on a few questions that were asked on Cubicure and Direct 3D printing earlier. Really exciting technology that you unveiled late last year, and definitely see the opportunity. But could you help walk us through the road map a little bit sort of like what should we be looking for as sort of goal post 6 months out, a year out, 2 years out, just to sort of track progress and see how it -- see how it's progressing?

好的。然後也許是對之前提出的有關 Cubicure 和直接 3D 列印的一些問題的後續討論。你們去年年底推出的技術非常令人興奮，我們肯定看到了機會。但是您能否幫助我們了解路線圖，就像我們應該尋找 6 個月後、一年後、兩年後的目標一樣，只是為了追蹤進度並看看它如何 - - 看看進展如何？

Michael, it's Joe again. I think the best way to describe it to you, it's -- like I said in my script, it's a 1- to 3-year journey. And obviously, we'll -- we know how to make these aligners now. We understand how to do it. It's just a scalability of resin in the Cubicure process and that takes time. And we'll obviously report on it quarter by quarter. So you really understand where we're going and what the hurdles are and what the opportunities are.

邁克爾，又是喬。我認為向您描述它的最佳方式是——就像我在劇本中所說的那樣，這是一個 1 到 3 年的旅程。顯然，我們現在知道如何製造這些矯正器。我們了解如何做。這只是 Cubicure 製程中樹脂的可擴展性，這需要時間。我們顯然會按季度報告這一情況。因此，您真正了解我們的發展方向、障礙和機會。

Okay. Maybe if I could just tweak that a little bit. Is there -- just help us understand, is there anything in terms of -- when you talk about scalability of the resin and the polymer, if you're looking at comprehensive, noncomprehensive, you talked about retainers and being able to put those. Is there anything in terms of your portfolio that makes some products more amenable or would be amenable earlier than others? Or is this just going to be all or nothing?

好的。也許我可以稍微調整一下。是否有——只是幫助我們理解，有沒有什麼——當你談論樹脂和聚合物的可擴展性時，如果你正在考慮全面的、非全面的，你談到了保持器並能夠放置它們。在您的產品組合中，是否有任何東西使某些產品更適合或比其他產品更早適合？或者這只是全部或全部？

I mean obviously, the scale, you look at retainers first because units of one. And that's why you'd end up with comprehensive full cases in some way. And that's basically how we'll ramp.

我的意思顯然是，規模，你先看保留者，因為單位為一。這就是為什麼你最終會以某種方式獲得全面的完整案例。這基本上就是我們的升級方式。

Our next question comes from Nathan Rich with Goldman Sachs.

我們的下一個問題來自高盛的內森·里奇。

I wanted to ask on the Systems and Services revenue guidance for 2024. This looks low to me just given -- I think growth in '23 was basically flat, up slightly. With the Lumina launch, we thought it would maybe be up more than it was in 2023. So I don't know if you could just maybe elaborate on what you're expecting for that segment?

我想詢問 2024 年的系統和服務收入指導。在我看來，剛剛給出的數字很低——我認為 23 年的增長基本上持平，略有上升。隨著 Lumina 的推出，我們認為它可能會比 2023 年增長更多。所以我不知道您是否可以詳細說明您對該細分市場的期望？

Nate, this is John. We're looking at, like we said, this year, you're kind of in that mid-single digits. We do have Lumina, which helps, but there's also unknowns about the macro economy. We were very pleased with what we saw in the fourth quarter with doctors buying and actually doing better than what we had really guided to. So we're pleased with the performance of Q4, but we just want to make sure that as we ramp up Lumina that we're properly positioned there, and we'll update as we go along.

內特，這是約翰。正如我們所說，今年我們的情況是在個位數左右。我們確實有 Lumina，這很有幫助，但宏觀經濟也存在未知數。我們對第四季度看到的醫生購買情況感到非常滿意，而且實際上做得比我們真正指導的更好。因此，我們對第四季度的表現感到滿意，但我們只是想確保，當我們提升 Lumina 時，我們處於正確的位置，並且我們會隨著進展進行更新。

Okay. Great. And then just going back to the margin cadence, I guess are there any either upfront or onetime costs associated with either the launches of Lumina or IPE that impact the margin in the early part of the year just as we think about cadence and sort of what the right baseline is.

好的。偉大的。然後回到利潤節奏，我想是否存在與 Lumina 或 IPE 的推出相關的任何前期成本或一次性成本，這些成本會影響今年年初的利潤率，就像我們考慮節奏和某種什麼一樣正確的基線是。

There is some of that in Q1. We're ramping that up. So it's not a big, huge splash where there's a lot of expenses and kind of hits all in 1 quarter. But there is some ramp up, but that's factored into our guidance. So when we say that we expect the year-over-year in the first quarter to be slightly up, it's factored in -- those expenses are factored in.

第一季有一些這樣的情況。我們正在加大力度。因此，這並不是一個巨大的轟動，在一個季度內就有大量的支出和一些點擊。但有一些增長，但這已納入我們的指導中。因此，當我們說我們預計第一季的同比將略有上升時，它已經考慮在內了——這些費用都被考慮在內了。

Our next question comes from Ann Wright with Morgan Stanley. You may proceed.

我們的下一個問題來自摩根士丹利的安·賴特 (Ann Wright)。您可以繼續。

You mentioned at the end of the call, some of the DTC customers that you are tailoring some of the offerings to. I guess, was this material at all in the quarter? Maybe it's not large enough at this point, but any sort of contributions in 2024 as we think about picking up some of that business? And then also, DSO relationships, has there been any changes there in terms of the relationships on that front? How would you characterize those at this point? Are you seeing any greater traction there? Do some of these new products really move the needle on some of those relationships or conversations you're having?

您在通話結束時提到，您正在為一些 DTC 客戶量身定制一些產品。我想，這個材料是在這個季度的嗎？也許目前還不夠大，但在 2024 年我們考慮接手部分業務時，會做出任何形式的貢獻嗎？另外，DSO 關係方面，這方面的關係是否有任何變化？此時您會如何描述這些特徵？您是否看到那裡有更大的吸引力？這些新產品中的一些真的能改善您正在進行的某些關係或對話嗎？

Ann, on the DTC customers, we've always argued that, that wasn't our marketplace in the sense of the price point and all. But I mean, obviously, these patients will pursue treatment. Now probably more so for doctors than DTC. And we're just doing what we can in order to support those customers going forward. But again, as I was clear in my script, we're a doctor-focused client company, and we'll keep it that way. But we do see this as being a certain opportunity. It's just hard for us to quantify right now.

安，關於 DTC 客戶，我們一直認為，從價格點等意義上來說，這不是我們的市場。但我的意思是，顯然這些患者會尋求治療。現在對醫生來說可能比 DTC 更重要。我們只是盡我們所能來支持這些客戶的未來。但同樣，正如我在劇本中明確指出的那樣，我們是一家以醫生為中心的客戶公司，我們將保持這種狀態。但我們確實認為這是一個機會。我們現在很難量化。

On the DSO relationships, I'd say this has gotten stronger all around the globe. Two to call out would be Heartland and (inaudible) being more new ortho side and Heartland being more on the GP side. But we have really good relationships and we leverage our portfolio well with them to help them grow and we grow with them. So I feel good about our position with DSOs, and we have good strong relationships out there with them.

關於 DSO 關係，我想說這段關係在全球範圍內變得更加牢固。需要指出的兩個是 Heartland 和（聽不清楚）是更新的正射側，而 Heartland 更偏向 GP 側。但我們與他們有著非常良好的關係，我們很好地利用我們的投資組合來幫助他們成長，我們也與他們一起成長。因此，我對我們在 DSO 中的地位感到滿意，並且我們與他們有著良好而牢固的關係。

Our next question comes from Brandon Couillard with Jefferies.

我們的下一個問題來自傑弗里斯的布蘭登·庫亞爾 (Brandon Couillard)。

Joe, given the positive macro shift we've seen in the last few months with consumer confidence coming back, any chance you can comment on what you've seen in case starts in January an inflection? And then with respect to the '24 growth outlook. Any chance you could break that out between Americas and International.

喬，考慮到過去幾個月我們看到的積極的宏觀轉變以及消費者信心的恢復，您是否可以對您所看到的情況發表評論，以防一月份開始出現拐點？然後是關於 24 年的成長前景。只要有機會，你就可以在美洲和國際之間打破這種局面。

Yes. I can't -- I really wouldn't break it out between Americas and International because we felt good about the geographies in general as you went across the world for especially latter half of the fourth quarter of last year. As we go into this year, as I talk about, we're looking at, I think, a stable economic platform. Some of the data that you cited would support that overall. And we feel good about our new products. We think we can play offense. And that's what we're focused on right now.

是的。我不能——我真的不會在美洲和國際之間進行區分，因為當你在世界各地尤其是去年第四季後半段時，我們對整體地理位置感覺良好。正如我所說，當我們進入今年時，我認為我們正在尋找一個穩定的經濟平台。您引用的一些數據總體上可以支持這一點。我們對我們的新產品感覺良好。我們認為我們可以進攻。這就是我們現在關注的重點。

Okay. And then one housekeeping one for you, John. The fourth quarter operating cash flow was pretty weak. Can you just unpack any of the moving parts that might have been onetime in the quarter. It looks like there was a spike in prepaid expenses on the balance sheet. But anything you would call out?

好的。然後是為你準備的一份家事服務，約翰。第四季營運現金流相當疲軟。你能把本季可能出現過的任何活動部件拆開嗎？資產負債表上的預付費用似乎激增。但有什麼想說的嗎？

Things that related to like tax payments and things. It's just some timing as things go through the year. But we feel great. I mean, it's a great model. It generates a lot of cash. It gives us a lot of flexibility, and we were able to use that cash, that $350 million buyback that we did last quarter.

與納稅等相關的事。這只是一年中事情發生的一些時機。但我們感覺很棒。我的意思是，這是一個很棒的模型。它產生大量現金。它給了我們很大的靈活性，我們能夠使用這些現金，即我們上季度進行的 3.5 億美元回購。

And 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.

我們的問答環節已經結束。現在，我將把電話轉回給雪莉史黛西（Shirley Stacy），讓其致閉幕詞。

Thank you, everyone. We appreciate you joining us today. We look forward to speaking with you at upcoming financial conferences and at industry meetings such as Chicago Midwinter. If you have any questions or follow-up, please contact our Investor Relations. Thanks, and have a great day.

謝謝大家。我們感謝您今天加入我們。我們期待在即將舉行的金融會議和芝加哥仲冬等行業會議上與您交談。如果您有任何疑問或後續事宜，請聯絡我們的投資者關係部。謝謝，祝你有美好的一天。

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

謝謝。今天的會議到此結束，此時您可以掛斷電話了。感謝您的參與。