Greetings, and welcome to the Align Q1 '21 Earnings Call. [Operator Instructions]. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Shirley Stacy, Vice President, Corporate Communications and Investor Relations. Please go ahead.

Good afternoon, and thank you for joining us. I'm Shirley Stacy, Vice President of Corporate Communications and Investor Relations. Joining me for today's call is Joe Hogan, President and CEO; and John Morici, CFO. We issued first quarter 2021 financial results today via Globe Newswire, 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. A telephone replay will be available today by approximately 5:30 p.m. Eastern Time through 5:30 p.m. Eastern Time on May 12. To access the telephone replay, domestic callers should dial 877-660-6853 with conference number 13718065 followed by pound. International callers should dial 201-612-7415 with the same conference number. 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 first quarter 2021 conference call slides on our website under Quarterly Results. Please refer to these files for more detailed information. Please note, as of Q1 '21, we are no longer including number of doctors trained, Clear Aligner shipment volume by region and total worldwide average selling price. We will continue to share information management uses to evaluate the business and metrics to help investors and analysts assess our financial performance. With that, I'll turn the call over to Align Technology's President and CEO, Joe Hogan. Joe?

Thanks, Shirley. Good afternoon, and thanks for joining us. On our call today, I'll provide some highlights from the first quarter, then briefly discuss the performance of our 2 operating segments, Clear Aligners and Systems and Services. John will provide more detail on our financial results and discuss our outlook for the full year. Following that, I'll come back and summarize a few key points and open the call to questions. I'm pleased to report another strong quarter with record revenues and volumes reflecting strong growth for both Invisalign Clear Aligners and iTero Systems and Services across products and customer channels worldwide. Q1 sequential Invisalign Clear Aligner growth was driven by strength in both adult and teen market segments across products, customer channels, especially in North America and the EMEA region. The year is off to a great start, and Q1 reflects increasing momentum and the benefit from continued investments in our strategic initiatives focusing on: expanding our operations globally in existing and emerging international markets; increasing ortho adoption and utilization of Invisalign treatment, especially with teens; training and education GP dentists; an increasing conversion to Clear Aligners; and building Invisalign brand preference with millions of consumers through advertising, PR, digital, social media and influencer marketing to drive demand and conversion through Invisalign-trained doctors. For Q1, total revenues were $894.8 million, up 7.2% sequentially and 62.4% year-over-year. Q1 System and Services were $141.5 million, up 5.8% sequentially and up 104% year-over-year. Q1 '21 Clear Aligner revenues of $753.3 million were up 7.5% sequentially and increased of 56.4% year-over-year. In Q1, we shipped a record 595,800 Invisalign cases, an increase of 4.9% sequentially and 65.8% year-over-year. In addition, we shipped to a record 78,600 Invisalign doctors worldwide, of which approximately 6,600 were first-time customers. During the quarter, we reached a significant…

Thanks, Joe. Now for our Q1 financial results. Total revenues for the first quarter were $894.8 million, up 7.2% from the prior quarter and up 62.4% from the corresponding quarter a year ago. For Clear Aligners, Q1 revenues of $753.3 million were up 7.5% sequentially and up 56.4% year-over-year, reflecting Invisalign volume growth in most geographies. Clear Aligner revenue growth was favorably impacted by foreign exchange of approximately $14.4 million or approximately 2.1 points sequentially and on a year-over-year basis, by approximately $22.3 million or approximately 4.6 points. For Q1, Invisalign Comprehensive and Non-Comprehensive ASPs were both up sequentially. On a year-over-year basis, Q1 Invisalign Comprehensive and Non-Comprehensive ASP decreased. Overall, on a sequential and year-over-year basis, ASPs were favorably impacted by foreign exchange. On a year-over-year basis, ASPs were impacted by higher net revenue deferrals in all regions and higher promotional discounts. Clear aligner deferred revenue on the balance sheet increased $79 million sequentially and $256 million year-over-year and will be recognized as the additional aligners are shipped. Total Q1 clear aligner shipments of 595,800 cases were up 4.9% sequentially and up 65.8% year-over-year. Our Systems and Services revenues for the first quarter was a record $141.5 million, up 5.8% sequentially due to product mix and increased services revenues from our larger installed base and exocad's CAD/CAM services. Year-over-year, Systems and Services revenues was up 104% due to higher scanner shipments and services and the inclusion of exocad's CAD/CAM services from the April 2020 acquisition and increased services from our larger installed base. Our Systems and Services deferred revenue was up 17% sequentially and up 102% year-over-year, primarily due to the increase in scanner sales and the deferral of service revenues, which will be recognized ratably over the service period. Moving on to gross margin. First quarter overall gross…

Thanks, John. In summary, we're very pleased with the first quarter results of 2021. Our strong growth and continued momentum reflect our strategic initiatives and investments, including support for doctors to ensure treatment and business continuity, ramping availability of virtual tools to keep doctors and patients connected throughout treatment and increased consumer marketing and concierge programs. The benefits of digital treatment and digital tools and the limitations of outdated old analog approaches continue to drive adoption of Invisalign Clear Aligners and iTero scanners and services. Over the past year, more doctors have experienced Align's digital platform, which made it possible for thousands of Invisalign practices and patients to continue treatments throughout global disruption, thanks to Invisalign aligners, digital treatment planning, virtual monitoring and care as well as iTero scanners. But the shift from traditional analog wires and brackets to a fully end-to-end digital platform is not easy, cannot be done without very complex technology. And this technology is prevalent, touching every aspect of what we do from manufacturing excellence where we currently manufacture over 700,000 unique aligners per day, to expanding our geographic footprint to over 100 markets, to building a network of over 200,000 trained Invisalign doctors and providing the technology to our doctors in a complete digital system, the Aligned digital platform. As the market leader in the clear aligner space, we have been building this industry over 24 years to get to where it is today and yet the majority of the market opportunity remains largely untapped. With over 500 million potential case starts globally, Align is in a rare position to address this market with the Align Digital Platform, powered by 2 decades of clinical data based on more than 10.2 million patients with AI machine learning and digital tools to help our doctors efficiently communicate…

[Operator Instructions]. The first question is from Nathan Rich from Goldman Sachs.

Maybe starting with the guidance for the year and your expectations over the balance of the year. I appreciate the detail that you gave. I guess, should we think about the revenue cadence as being similar to a normal year? And Joe, I mean, it certainly seems like the shift in market share that you've been highlighting has accelerated during the pandemic. I guess I'd be curious to know if you have any way of kind of quantifying the magnitude of this shift as we think about the ability of -- you just kind of sustain this momentum going forward and the gains that obviously Clear Aligners has had during the pandemic.

All right. Nathan, we're obviously optimistic. I mean, given the guidance we had today and the strong first quarter results, we really feel good about where we are. The great thing about this growth is it's been broad and deep, okay? It is across every region. We see it whether it's in APAC, or whether it's EMEA, whether it's in the Americas overall. And then across the GP spectrum, across the ortho spectrum, too, it's been terrific. And it's also up and down. That's why we're giving you comprehensive, noncomprehensive now, all different kinds of cases. So we just feel great about the demand patterns, the depth and breadth of this rebound and that's why we have some clarity now. We decided to give guidance, and we're excited about this year and going forward. John, any thoughts on it?

And to add to your question, Nathan, the seasonality and things that we've seen in the past will continue. We would expect those to continue as we go through this year. So it's hard to compare year-over-year, especially in the first half. But going forward, it makes sense to look at it quarter-over-quarter.

Great. And if I could just ask a quick follow-up on the -- it seems like it's going to -- there's going to be more discussion around comprehensive versus noncomprehensive instead of the regional breakout going forward. So I was wondering if you could just level set us on the current mix of business between comprehensive and non-comprehensive cases. And how you're thinking about the growth of those two categories going forward?

Yes. When you look at it, Nathan, it's about 75% comprehensive, 25% noncomprehensive. It can vary by quarter based on teen season and so on, but that's roughly the split there. And we're investing in both areas to be able to grow, whether it's on the ortho side or the GP side for those categories.

And Nate, I think you know the margin on those products also. So there's not -- this is not like a margin split. I mean, you still have higher margins on the less than comprehensive product line, too. So it's a good mix.

The next question is from Jason Bednar from Piper Sandler.

Congrats on a really nice quarter here. I actually want to start on guidance as well. If I focus in the second half of the year, maybe when comps tend to normalize a bit and use the midpoint of that 20% to 30% long-term guide you've got out there. Are you able to talk about how this comes together from a regional or channel perspective? Is it safe to assume that teens international still grows above that mid-20s level? And then is it right to think about imaging and CAD/CAM growing at that mid-20s level as well?

Jason, this is John. We would look at Invisalign and our System and Services to grow at that midpoint in the second half, so around that 25% year-over-year across the business. And we're making investments and continued investments, as we've talked about, to really establish and continue our growth.

Okay. And John, just sorry, anything from a regional or channel perspective, international or teens or just how that all comes together?

I think we're not forecasting by each of the regions and so on from that. I think you can -- from our business, we're trying to grow teens. It's a great indicator for the penetration on the ortho side, and we'll continue to grow that, but not giving specifics by region.

Okay. Understood. And then just one other follow-up. I mean, the Clear Aligner gross margin was extremely strong this quarter. The Clear Aligner revenue, that grew $50 million sequentially with COGS that fell by $10 million. John, I know you stepped through some of the factors just incorporated there. But is this a sustainable level that we should be thinking about for Clear Aligner gross margin going forward, kind of in this upper 70s level? Or maybe were there some other factors that helped push that gross margin higher here just in the first quarter?

Well, we did see some FX benefit, as we called out, but it's a reflection of investing in this business, adding capacity, adding in places where we see the growth, and this was leveraging some of that -- those investments. So it's a reflection of the work that we have, the productivity that we can drive across the business, utilizing some of the facilities that we have and then benefit a bit from FX on a quarter-over-quarter basis.

The next question is from Elizabeth Anderson from Evercore.

Congrats on a nice quarter. Can you talk about any changes in your DSO strategy? I know you obviously, highlighted the DECA renewal in the quarter, but I just didn't know if there -- as we come out of COVID, anything to think about there in terms of how you're working with that group of customers?

No, Elizabeth, actually, we do, we can. We bring the entire Align digital platform together with iTero, the different -- some DSOs want to approach this thing from a comprehensive standpoint, some want noncomprehensive. So we just basically gear our digital platform and our product line based on what a DSO wants to do and what they want to accomplish, and not just in the U.S. but really all over the world.

Got it. That's helpful. And then in terms of the new facility in Poland, should we think about the potential impact on the gross margin line to be similar to when you open the Ziyang facility? Or is there a different way that you -- that this one is different?

I think when we look at that, we'll leverage to ramp up that facility as fast as possible as a lot of volume can come through from EMEA. So I wouldn't look at that as a model for that. Remember what we did in China was a temporary facility to move to a greenfield, and this is a greenfield new facility to start with.

The next question is from Jon Block from Stifel.

Joe, nice quarter. Two relatively quick ones. I guess to start, Joe, you called out EMEA and North America as the primary case volume, call it, upside drivers, not APAC. And just maybe if you could talk to APAC a little bit more. It was sort of first in COVID, and I think everyone was thinking first in, first out, but it seems like EMEA has been stronger. I mean, it was on a 2-year stack basis despite all the headline stuff that we hear in EMEA. Any details on APAC? Obviously, you've got a pretty big competitor in China. Any more granularity there would be very helpful. And then I've got a little bit of a tighter follow-up.

Jon, first of all, I mean, EMEA was amazing in that way, but I wouldn't let it eclipse APAC, right? We feel really good about APAC across the board. China, obviously, being a big area, the sequential growth of China. When you look at fourth quarter versus first quarter, it's right in that 7%, 7.5% range like the entire business is. And then obviously, APAC is extremely diverse, but from Japan, ANZ, those key areas that we have in APAC, it's really strong growth. So I really feel great about APAC. It's just there's somewhat of an eclipse right now because EMEA was extremely strong. But you shouldn't let yourself think in any way that, that means APAC was weak in some way. We feel good about APAC as we go into the first quarter and the whole year.

Okay. Yes, I guess, good problem to have. Second one is sort of a derivative of Nathan's question. But the biggest question I get from investors is this pull-forward of demand, right? In other words, is the 1Q '21 volume, call it, success, is that at the expense of future quarters? And it seems like your guidance suggests you're not too worried about that, Joe. But can you give us more detail here? Like why aren't you worried about any pull-forward? What are you hearing from sales reps? What are docs saying about sustaining the momentum throughout the year?

Yes, John. John, first of all, it's the breadth of this growth, right? It's not like it's a singular region like we just talked about with EMEA and APAC and how strong the Americas is. We're seeing great uptake in the GP side. We see terrific growth there, the orthodontic side. You see our team numbers are good and respectable. We're moving in the teen season. So what we feel good about is just the breadth and depth of this business. It's not just leaning on 1 or 2 legs from a strategy standpoint, it really is well positioned going forward. We hear the same thing about demand pull-forward or whatever. We -- doctors aren't talking like that. Remember, the questions back in the third quarter, fourth quarter was backlog, right? How much of this was backlog that wasn't consummated in second quarter, early third quarter. And we got way past that. Obviously, we got into the fourth quarter, whatever. So I think we're just seeing a realization in the adult and the teen market of what digital orthodontics can do. And our company is very well positioned to take advantage of that when you look throughout the world. John, anything to add?

Okay.

The next question is from Kevin Caliendo from UBS.

I want to talk a little bit about how to think about seasonality with regards to teens. You typically -- you gear up the summer, it's a big teen season historically. Has there -- do you expect that again next year as sort of back-to-school might be a little more normal? And what -- how should we think about you gearing up for another incremental teen season? What might be different? Any expectations around incremental share for teens? I'd just love to hear the strategy.

Well, I think we have a strategy really based on every region because the teen season is different by region from a calendar standpoint. And doctors apply our technology in different ways with teens. But let's just take U.S. and Canada for a second. Obviously, in the second quarter, beginning of third quarter, those are the really strong areas where you'll see our advertising program really kick in, in a big way. We talked about the Teen Awesomeness Centers that we put in place. That's with making sure that we have doctors that are really well-equipped to handle teens, and we direct the leads to that teams with confidence that they can be serviced properly. Overseas, we understand what those timing are for the teens also, and we put those programs together, too. Honestly, Kevin, we have a great portfolio, right? And we can go across teens in a lot of different ways, all the way from 6 year olds, to really older teens when you get to 16 to 19 years old, and the tooth movements associated with those two. So it's just having those doctors ready. It's having the communications with the teens and the moms to make sure they're aware of a digital orthodontic option, and they really ask for that as they go into the doctors. And that's a strategy we apply just in different ways and different seasons around the world, but it specifically applies to teens.

That's helpful. And one -- just one follow-up on margins. The gross margin number was mentioned. You covered that already. Should we think about any of that flowing down to the operating margin? Or any sort of target for operating margins over the next couple of years? You've historically always looked to spend to grow, and it's always -- you've always been rewarded for it. There's no reason to change. But just thinking sort of where you are now, maybe if you do have a little bit of an uptick in the gross margin that you can let more of it flow through to the operating side. How do you think about that?

I think when you look at it -- Kevin, this is John. I mean, we're looking to balance our growth opportunities with our margin. And in certain countries, you might be at different parts of that equation. But on balance, we're pleased with the gross margin. We've talked a lot about the investments, the productivity and other things that we see, and that continues. And it gives us a lot of flexibility to be able to invest. But in a vastly underpenetrated market that we're in, making these investments to grow volume make a lot of sense to us. But we're always mindful of that balance between volume and margin.

The next question is from Ravi Misra from Berenberg Capital Markets.

So just want to press a little bit more on kind of just some of the marketing opportunities that you're highlighting. And just curious, you have the ski team now, you're talking about the Golden State Warriors. I'm sure Draymond Green is not very happy about that. But just can you help us understand, like, what do you go after when you look at the marketing opportunity? Like in terms of the return that you're searching for the particular brands that you're aligning with? And then I have a follow-up after that.

We do a lot of work on this, just figuring out what channels, what kind of return we get by channel, how much you put in social media, sports team, how much do you put in television. But overall, John and I expect a certain return, and we know what those returns are by region. We invest a dollar here, we know what we get back. I don't necessarily want to convey exactly what those returns are but we make sure they're positive. And you've seen us increase our advertising pretty dramatically outside the United States. The response for that has been really good. And obviously, we use a lot of what we learned here in North America to apply that around the world. So Invisalign is an incredibly well-known brand, not just in North America, but all around the world. And being to leverage that and having that as kind of a common name around the world, it's very helpful for us in the sense of driving volumes, giving doctors confidence and patients confidence, too. So we really feel good about our investments. And obviously, we balance that well with increased salespeople, with technology investments, all the things you have to do when you run a business like this, but it is something that obviously gains a lot of attention and a lot of analysis from us.

Great. And then maybe just one on -- on the press release, something caught my eye around your kind of Ortho Summit Case Shoot-out where the highest vote was around kind of a Class II/Class III Invisalign case presentation. Historically, that's been something -- I think maybe -- that unless you're a bleeding edge KOL or doctor that you weren't doing. The fact that, that's kind of winning the kind of peer award now, does that suggest that you're getting deeper into these more complicated cases? And just more specifically, do you feel that you have an edge versus your competitors in the space that allow you to do this? Or is this kind of a class effect that you think has to do with comfort and ease of use of the technology as a whole?

Yes, Ravi, it's a good question. Look, remember, we have -- we've done, what, we said 10.2 million cases. And through those 10.2 million cases, we've learned a lot, and we learn more every day. And we run AI and machine learning across those cases. And that's how we just launched GA, as we understood and defined cases. We have some issues with posterior open bite and different clinical kind of issues that would bore you to death, but we understand based on millions of cases that we have done, which is the best way to move those teeth to ensure that they end up in the right positions with the right smile at -- obviously, you want to do this as quickly as you possibly can because patients don't want to be in treatment over 5 years. So I feel we have an incredible advantage. You look at SmartTrack, you look at how we initiate that with over 4 million lines of codes that we have in ClinCheck. You look at the accuracy of iTero in the sense of transferring information through over to our manufacturing facility in order to make this. It's so -- and I feel very confident about a 24-year first-mover advantage on what we've done. Now obviously, there's competitors out there and competitors are coming up. But a lot of them have to crawl through the friction that we did in order to learn this. And a lot of the IP that we've put down that makes us unique in the sense of how we position ourselves in the marketplace. So back to what you started with, when you do these shoot-outs and all, it's really great to sit in the audience and look at the before and after photos. I mean it's amazing. When I first joined this business, I just said, I -- hard to believe that you can do this. What's happening today is it's becoming more common. I mean you go all around the world. It was -- it's not 1 or 2 doctors doing this. There's hundreds, if not thousands, that are doing incredible kinds of cases. And so -- which I think that more and more, it just lends credibility to this product line. It can do what we say now 90% of all the cases that are out there. That's not just because it's plastic, right? It is the whole system from how we 3D print, what plastic we use, the algorithms we use, how we constantly tweak it by the information that we have, driving a brand like this, having the kind of training. We talked about 200,000 doctors that we've trained who've gone through these things. This takes time to do, it takes expertise. And doctors need that confidence in understanding. And we feel we can give it to them better than anyone.

And that technology is brought about by investments, and we'll invest over $250 million this year alone in R&D to improve our systems and Invisalign for our customers. And that's an advantage. It's an advantage, like Joe said, over a period of time, but we're continuing to invest to make things better and better for our customers.

The next question is from Richard Newitter from SVB Leerink.

This is Jaime on for Rich. Just one question for me. Appreciating that you guys are obviously focused on driving higher ortho teen utilization, overall GP adoption at the same time. I'm just curious, in your view, which of the 2 is likely to be the bigger make-or-break driver of growth over the near to intermediate term?

You know, it just sounds like a terrible answer to you, but they're both. Really, we talk about 500 million patients out there that could use Invisalign treatment. We know that of the 15 million orthodontic cases, roughly 75% to 80% are teens -- I mean all those -- they're both huge opportunities. And there's not a difference from a technology standpoint or how you apply that technology to either of those that would make one easier to do or more beneficial than another. So honestly, both of those are great reservoirs of growth for us.

Got it. Okay. And then just...

Go ahead, Jaime.

One last one for me, just on the DSO. Kind of the business model and strategy that you guys have for entrenching iTero systems in DSOs across all practices, kind of how do you approach that? And when you do see DSOs where the large majority of their practices have adopt the iTero scanner, what's the sort of pickup that you guys see in terms of utilization?

Well, where you use iTero scanners, you train the doctors properly, you have the right products in a GP channel like iGo and different products like that. We get terrific uptake. I mean, you can't measure it the way you do share a chair at the orthodontic office. But we get -- our DSO business is significant now. It's meaningful that way. And it's one where that digital platform strategy, as you kind of outlined in your question, is what we employ. But again, we employ it in different ways, depending on how a DSO really wants to engage with us.

Next question is from Jeff Johnson from Baird.

John, I want to go back. You mentioned the $250 million in R&D. And I think the number we've discussed over the last, I don't know, probably somewhere in the last 6 or 9 months or so, it's like $500 million total of what you guys spend, not only on R&D, but channel support, advertising, social media, all that stuff. And on our mind, that's one of your bigger barriers to entry, even probably more so than some of the IP and what have you. But it sounds like with some of the stuff, you're taking up EMEA, you're taking up APAC advertising, more and more sports teams and things like that. Is that $500 million number a dated number at this point? Is that barrier to entry and that spend even going well above that number in the near to intermediate term?

You will see that. That's a good question, Jeff. We talked about that at our last Investor Day, about the $500 million combined kind of the marketing go-to-market plus the R&D. And what you'll see is as in success. And we've talked about a lot, as you know, where we see returns, where we see volume, where we see profitability, we're going to continue to make those investments. So as we go through this year, that number will most likely go up as we find success in these investments and find that right return.

Yes. Fair enough. And Joe, I'd be interested. I mean, we saw COVID case counts and restrictions even in the 1Q in some of the markets you called out in EMEA as being so strong, U.K., France. I'm sure some others, you called out other areas. Obviously. India that we're all watching closely, but a lot of other markets as well that are still dealing with COVID case counts and heightened risks there. Does that even matter to case shipments to Invisalign at this point? I guess what I'm trying to figure out is, is that stuff holding back some volumes that could come through next year? Are we all just with COVID fatigue still comfortable going in and getting Clear Aligner cases even in those markets? So is COVID a risk factor, I guess, that you've had to build in some caution in the guidance for in some of those markets? Or are cases just as strong in those markets as they are in markets where maybe COVID is a little more under control?

Yes. Jeff, it's a good question. It's just what we've seen. There's one definitive. If offices are shut down and patients aren't allowed to go to offices, we saw that. That happened in the second quarter, it happened all around the world. And then the term lockdown is used very loosely all around the world, what's a lockdown and what isn't. The situations like in India right now are a disaster, obviously, and people are very cautious. But the rest of the way around the world, what we see is it looks like communities and people have been able to manage this, okay? Is there any kind of a backlog of patients not going into dental offices because of that? I think in certain countries around the world, there is, but we can't really quantify that right now. And again, the breadth and depth of our demand pattern gives us confidence that we think we can predict around it.

The next question is from Erin Wright from Crédit Suisse.

Great. Can you speak a little bit about what you're doing differently in terms of promotions or other initiatives around iTero that's really resonating with customers maybe differently now? And where is the traction mostly tied to, on the ortho or GP channel? And do you anticipate any lumpiness quarter-to-quarter across that business?

Yes. Well, iTero's been great for us, right? You have a good services business there. We announced the Plus series iTero, which is -- Erin, it's a breakthrough. I mean, it sounds like it's a derivative as far as incremental but it is really a strong platform. We talk about the artificial intelligence we've been able to embed in that machine. We see doctors, both on the GP side and the orthodontic side, really excited about it. This is not a promotional discussion in a sense of when you ask your question about how to promote it. There's nothing tricky there. What we do is we have a broad number of products. You have the NIRI product plus, which is the very high end of the product line. Then you have a flex system, which I mentioned in my opening, which is basically a wand itself and it's used with the -- a normal kind of a computer that's adapted to that. And it helps to get flexibility in the sense of what a customer wants to use or a doctor wants to use on both ends. So I feel it's like how we take this to market, the different products that we have and the different way that we segment that is -- and then, obviously, if you want to do Invisalign, this is the front end, the key end of our digital platform and that's very attractive to both GPs and orthos that really want to do Invisalign. They know that iTero is critical for that.

The next question is from Brandon Couillard from Jefferies.

John, maybe just a two part question around guidance. The operating margin outlook would suggest your margins kind of moderate a bit over the balance of the year from 1Q levels. Can you sort of elaborate on your expectations for gross margins for the balance of the year? And then what should we -- how should we think about the trend of ASPs over the next few quarters? I'd just leave it there.

Yes. Brandon, when we look at -- we're pleased with our gross margin and margins that we had in the first quarter. A lot of things came together on that. When we look at the investments and the growth opportunities we have, we're not giving specific guidance around our gross margin. What you can see as it translates to op margins, it's a reflection of the growth opportunities we have, the investment opportunities that we have to be able to invest and grow in this business. And we can update as we go forward based on what we see. Your other part of the question regarding kind of ASPs and so on. When you look at -- we have a breakout, and we show that on a regular basis between comprehensive and noncomprehensive. We don't expect any major fluctuation across our ASPs. The only thing that comes up, and we saw it in this quarter a bit was with currency changes. But in terms of the promotions and how we go about the business and how we're trying to drive growth, there's nothing out of the ordinary that would impact ASPs.

The next question is from John Kreger from William Blair.

I just wanted to follow-up on Jeff's question a bit. So if you move beyond office closures, as you look at certain regions of the world becoming hot spots and then that fading, does that impact demand levels that you're seeing?

It's not a great answer for us, John, it's yes and no, okay? Depending on the severity and where it is, I can say yes. For the most part, we say no. And that's after the second quarter when, again, the definitive piece, if you shut offices down and you won't let patients in there, we're going to have an issue. But actually, after the second quarter, early third quarter, we've been dealing with lockdowns that are basically lockdowns of time frame, lockdowns of where people can travel, but not specific lockdowns of doctor offices. If the market stays away from that, we feel we're pretty good.

Thanks, John. Operator, we'll take one more question.

The next question is from Michael Ryskin of Bank of America.

I'll just ask a quick one. Sort of want to expand a little bit on the ASP question that was just asked. I'm just wondering, you cited a little bit in your prepared remarks in terms of promotional things like that, discounts. Are you referring specifically to the Advantage program? And if you could talk about how some of the orthos and GPs are falling in with those tiers. Have you seen any movement over the last couple of quarters where people are falling more into the platinum and the diamond grouping there? Kind of also backing into sort of the numbers on utilization between ortho, I've seen some really nice numbers the last couple of quarters. Is that indicative of that, a higher portion of orthos and GPs falling at those higher tiers and therefore, walking in those -- the higher promotional discounts?

Yes. Certainly, that is an impact. When you have -- as doctors grow through the tiers, they become more proficient. They had taken on more cases, whether they're on the ortho side or the GP side, we see them work their way through tiers. They do more cases, then we get that volume benefit. And then they'll see those discounts there. We've had those programs in place. Those programs really help drive utilization and really talk to the utilization growth that you noted there. So those are programs that we've had. They're there to drive utilization, and it's something that we've used in our business and expect to continue to use.

This concludes the question-and-answer session. I'd like to turn the call back over to Shirley Stacy for closing remarks.

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