MAUDE Adverse Event Report: ALIGN TECHNOLOGY, INC. INVISALIGN GO; ALIGNER, SEQUENTIAL

Model Number	9014
Medical Device Problem Code	Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Code	Tooth Loss (4831)
Date of Event	06/01/2025
Type of Reportable Event	Serious Injury
Additional Manufacturer Narrative
The current instructions for use contains the following: "precautions - a tooth that has been previously traumatized or significantly restored may be aggravated.In rare instances, the useful life of the tooth may be reduced, the tooth may require additional dental treatment such as endodontic and/or additional restorative work, and/or the tooth may be lost.".The treating doctor clarified that the tooth loss was due to an internal root resorption, and the treatment was not the direct cause, however; the treatment aggravated the tooth condition.Align's clinical review of available records signs of cervical root resorption in tooth 2.1 were already evident.If this damage was indeed present before treatment began, it is plausible that the orthodontic movements may have accelerated the resorption process, ultimately leading to the reported extraction.No conclusive evidence has been provided that supports or opposes whether the invisalign system aligners caused or contributed to the tooth loss (permanent damage) and the invisalign system aligners were being used.Therefore, an mdr is being filed in the united states per 21 cfr 803.There is no conclusive evidence to confirm the date of the required tooth extraction, and the date (b3) is based on the timelines reported to align and compared to patient information.
Event or Problem Description
The treated patient reported that had an unexpected extraction (tooth 2.1).The patient didn't need any medical intervention, and medications were not prescribed for this patient.

• Brand Name: INVISALIGN GO
• Common Device Name: ALIGNER, SEQUENTIAL
• Manufacturer (Section D): ALIGN TECHNOLOGY, INC.; 2820 orchard parkway; san jose CA 95134
• Manufacturer (Section G): ALIGN TECHNOLOGY, INC.; 2820 orchard parkway; san jose CA 95134
• Manufacturer Contact: janier duarte santana ; 2820 orchard parkway; san jose, CA 95134
• MDR Report Key: 23301693
• Report Number: 2953749-2025-02556
• Device Sequence Number: 21339226
• Product Code: NXC
• UDI-Device Identifier: 00816063020424
• UDI-Public: (01)00816063020424(10)0166686984(13)231107(91)2077073801N
• Combination Product (Y/N): N
• Initial Reporter Country: FR
• PMA/510(K) Number: K241412
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Consumer,Health Professional
• Initial Reporter Occupation: Non-Healthcare Professional
• Type of Report: Initial
• Report Date (Section B): 10/15/2025

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: No
• Operator of Device: Lay User/Patient
• Device Model Number: 9014
• Device Lot Number: 166686984
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 06/12/2025
• Initial Report FDA Received Date: 10/15/2025
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 07/11/2023
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Outcome Attributed to Adverse Event: Disability
• Patient Age: 37 YR
• Patient Sex: Female