Dr. Fernando Boccio on In-Office Aligner Manufacturing
- 2 hours ago
- 4 min read
Is It Really Worth It?
Dr. Fernando Boccio is a leading orthodontist based in Huelva, Spain, and runs one of the largest orthodontic clinics in the country. Over the years, he has also built one of the most advanced high-volume in-house clear aligner manufacturing setups in Spain.
That combination makes his perspective unusually valuable.
Few clinicians have both scaled a large clinical operation and built a complex internal aligner production workflow. Dr. Boccio has done both. His analysis is therefore not theoretical — it is rooted in operational reality.
In his analysis, Dr. Boccio breaks this decision down through the lens of real clinical operations, costs, and workflow realities.
Before diving deeper, let’s start with the highlights.
Key Takeaways
In-house aligner production is far more complex than it first appears
Hidden costs often outweigh expected savings
Doctor and staff time become major limiting factors
True per-aligner cost can rival — or exceed — outsourced manufacturing
Modern OEM partners change the economics entirely
1. What does it really take to manufacture aligners In-Office?
At first glance, in-office aligner production may appear straightforward.
Print models. Thermoform. Trim. Deliver.
In reality, the workflow is significantly more demanding.
3D Printing of Models
The first step is producing physical models using resin 3D printing — where clinics face an early strategic decision:
Low-cost printers
Allow the use of open, cheaper resins but require constant staff involvement: refilling resin, cleaning vats, removing prints, recalibration, troubleshooting.
Professional printers
Provide better consistency and reliability but require proprietary resins that are significantly more expensive and demand much higher upfront investment.
Depending on the system, the cost per printed model typically ranges between €0.40 and €1.80.
But this is only the visible cost.
All printers eventually fail. In clinics with volume, duplication of machines becomes necessary to prevent production stops — increasing capital investment and the true cost per aligner.
Post-Processing
Printed models must be washed, cured, dried, inspected, and sorted by patient and stage.
Simple steps. Significant time consumption.
At scale, these “small tasks” become an operational load of their own.
Aligner Materials
Most premium aligners rely on multilayer materials offering improved elasticity and more consistent force delivery. More economical monolayer options are also available.
Typical material cost ranges between €1 and €3 per aligner.
Again — a visible cost, not the full cost.
Thermoforming
Each model requires positioning, sheet placement, heating, forming.
Machine choice becomes critical. Breakdown risk persists. Duplication is often required.
Trimming
Manual trimming introduces further constraints.
A trained assistant may trim 45–50 aligners per hour, typically with straight cuts. Gingival-following or scalloped cuts are rarely viable manually at scale.
Finish quality seldom matches industrial laser trimming.
Organization & Delivery
Aligners must be paired, bagged, labeled, staged. Precision required. Time required.
Every step consumes clinical resources.
2. The software reality
Large commercial aligner brands have invested enormous resources into proprietary planning software.
These systems are continuously refined and financed by aligner sales.
Independent software solutions have evolved significantly and today can perform approximately 98% of required clinical planning functions.
However:
Greater manual intervention
Increased doctor involvement
External technicians not inherently included
Additional service costs often required
Software pricing models vary widely:
Per-case fees
Export charges
Subscriptions
Hybrid models
Software cost — and doctor time — must be factored into any realistic evaluation.
3. The true cost question
When clinics calculate aligner production costs, material pricing often dominates the discussion.
Resin. Sheets. Software.
But Dr. Boccio highlights a deeper reality: True cost extends far beyond materials.
It includes:
Staff time
Doctor time
Equipment investment
Maintenance
Repairs
Machine duplication
Operational friction
When all variables are included, the cost per aligner can approach — and in many clinics even exceed — outsourced manufacturing, particularly when volume is moderate or workflows are not perfectly optimized.
As Dr. Boccio notes:
“When all costs are included, in-house aligners can equal or even exceed commercial aligners.”
Not just financially.
But in time, focus, and operational complexity.
4. The OEM shift
Modern OEM manufacturers introduce a fundamentally different model.
Clinics send STL files and receive:
Manufactured aligners
Industrial trimming
Bagged and labeled
Ready for delivery
Typically within one week.
At highly competitive pricing.
This model removes:
Printing
Post-processing
Thermoforming
Trimming from the clinic entirely.
The economic equation changes dramatically.
Clinics retain diagnostic and planning control while eliminating operational burden.
5. Clinical & Strategic advantages
This approach enables:
Hybrid orthodontics without package restrictions
Greater mechanical flexibility
Same-day treatment starts
Reduced operational load
Consistent industrial finish quality
Material customization
Predictable production timelines
Aligners return to their intended role: a clinical tool, not a production process.
6. Limitations to Consider
For clinics pursuing in-house production:
High initial investment
Staff dependency
Training burden
Doctor time consumption
Finish quality limitations
7. Conclusion
In-office aligner manufacturing is neither inherently right nor wrong.
It is a strategic decision.
One that must align with clinical volume, operational capacity, and long-term objectives.
For many clinics, Dr. Boccio concludes that the most efficient model is hybrid:
Diagnostics and planning remain in-house
Manufacturing is outsourced to specialized OEM partners
This structure preserves clinical control while eliminating operational overload and reducing hidden costs.
The goal is not to become a manufacturer.
The goal is to unlock freedom, scalability, and efficiency.
And to use aligners as they were meant to be used.
Ready to implement the expert-recommended OEM model?
The hidden costs of equipment, staff, and time are real. K Line provides the solution Dr. Boccio describes: a dedicated OEM partner that delivers precision manufactured aligners, allowing you to focus entirely on patient care and practice expansion.
✔ Seamlessly integrate our production into your workflow
✔ Predictable costs and reliable, high-quality output
✔ Focus on clinical excellence, not production logistics
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