A dentist scanning a patient's mouth might unwittingly steer toward a single supplier of dental aligners. That suspicion has led Brussels to turn its spotlight on Align Technology, the California-based company behind the Invisalign brand and the iTero intra-oral scanning devices. The European Commission has opened a formal antitrust investigation to determine whether the practice of tying – the forced commercial link between two products – is shutting rivals out of the clear aligner market across the European Economic Area.

How tying works and why it raises alarms

In competition law, tying occurs when a dominant firm makes the sale or full functionality of one product conditional on the purchase of another. It is not illegal per se; it becomes a problem when the company has enough market power to leverage its strength from one market to another, stifling competition. Align manufactures both the iTero scanners – which produce 3D models of dental arches – and Invisalign aligners, the benchmark brand in clear orthodontics. The Commission suspects that the software and features of the scanners are configured to steer dentists toward Align’s aligners, thereby sidelining rival manufacturers.

A market under pressure and a competitor’s complaint

The investigation stems from a complaint by a competitor, a typical pathway for antitrust proceedings. The clear aligner sector is highly dynamic: alongside Invisalign, numerous challengers have emerged, often offering lower-cost alternatives. Align has already responded with intense legal activity, including patent infringement lawsuits and trade disputes. Brussels’ move now adds another layer of pressure, potentially slowing the American company’s defensive strategy.

The common thread with Big Tech regulation

For the European Commission, the Align probe is not a bolt from the blue. Brussels has built much of its modern antitrust doctrine on tying and bundling cases, hitting giants such as Google, Apple, and Meta. Applying those same principles to a dental scanner and an aligner may seem like a leap in scale, but the legal reasoning is identical: a company cannot use its position in one market to lock up another. The investigation confirms the EU’s willingness to scrutinize the conduct of dominant American firms operating in the single market, extending its regulatory gaze well beyond digital services.

Timelines and possible outcomes

Opening a formal proceeding signals that the Commission considers the concerns well-founded, but it does not amount to a conviction. The inquiry could last years and end with a heavy fine, the imposition of behavioral commitments (such as commercially separating the two products), or a decision to close the case. Align will have the chance to defend itself, arguing that scanner-aligner integration serves clinical rather than anti-competitive purposes. Meanwhile, regulatory uncertainty weighs on a company that earns a large share of its revenue in Europe, now facing a battle on two fronts: rivals and regulators.

The question Brussels has posed is surgical: are the scanner and the aligner tied too tightly together? The answer will define the limits of what a dominant company can do when designing a product ecosystem, even in sectors seemingly distant from digital technology. For Align, the investigation is a warning: in Europe, a dominant position is not a privilege but a constraint.