Glenn Coleman
Executive Vice President, Chief Financial Officer at DENTSPLY SIRONA
Thanks, Simon. Good morning, and thank you all for joining us. Today, I'll provide more detail on our first quarter results and an update on our full-year 2024 outlook.
Let's begin on slide five. Our first quarter revenue was $953 million, representing a decline of 2.6% over the prior year quarter. On an organic basis, sales declined 1.9% as foreign currency negatively impacted sales by approximately $7 million, or 70 basis points. On a constant currency basis, sales highlights in the quarter included approximately 53% growth in China, 14% growth in our global aligners business, 9% growth in CAD/CAM, and 5% growth in Wellspect Healthcare. These improvements are offset by declines in imaging equipment, where we continue to experience the effects of market conditions and increased competition. In addition, our essential dental solutions segment had year-over-year declines, largely due to a tougher comp.
Despite lower sales, EBITDA margins expanded 30 basis points due to restructuring savings and net investment hedges. Gross margin was flat year-over-year, but improved 140 basis points on a sequential basis. Adjusted EPS and the quarter was $0.42, up 8% from prior year, largely due to higher EBITDA margins, lower share count, and a lower effective tax rate. In the first quarter, we generated $25 million of operating cash flow compared to an outflow of $21 million in the prior year quarter. The year-over-year improvement is attributed to improved cash collections and a lower build of inventory.
We continued to maintain a strong balance sheet with cash and cash equivalents of $291 million on March 31. Our Q1 leverage ratio was 2.6 times. Slightly higher than a long-term targeted rate of 2.5 times. We expect leverage to increase marginally in the second quarter, with a plan to end the year at approximately 2.5 times. These projected leverage ratios reflect the share repurchases that Simon noted earlier.
Let's now turn to first quarter segment performance on slide six. Starting with the Essential Dental Solutions segment, which includes endo, resto and preventive products, organic sales declined 5.5% due to tough year-over-year comp. As a reminder, EDS organic sales grew 11.5% in the first quarter of 2023, which benefited from a strong rebound in patient traffic and prebuying ahead of price increases.
Shifting to the Orthodontic and Implant Solutions segment, organic sales grew 5.6%, with strong growth from aligners up 14%. SureSmile, our professional aligner brand grew 9% and continues to benefit from market share gains, new product offerings and differentiated outcomes. We're expanding further in certain international markets, including Japan and Brazil, which we believe will lead to continued momentum in SureSmile. Byte, our direct-to-consumer aligner brand grew 18% over the prior year quarter. Byte growth accelerated through the period as the increase in customer interest in impression kit orders that we discussed on our last earnings call, began to convert to aligner cases.
Implants & Prosthetics grew low single digits in the quarter, highlighted by growth in China due to [Indecipherable] and partially offset by declines in the US and Europe. Our value implant segment delivered double-digit growth and on the premium side, the new EV family of implants and prosthetic solutions grew double digits, outpacing the declines we have seen in legacy brands.
Wrapping up our dental performance, CTS, our Connected Technology Solutions segment, saw organic sales declined 5.7% versus the prior year quarter and was below our expectations largely due to double-digit declines in imaging equipment. Our global CAD/CAM business was a bright spot and grew high single digits driven by increased demand in the US.
Moving to Wellspect Healthcare, organic sales grew about 5%, with sales growth across all regions as we continue to benefit from new products launched in the last 12 months. We expect Wellspect to grow faster in the second quarter with high single-digit growth over the prior year.
Now let's turn to slide seven to discuss first quarter financial performance by region. US organic sales grew 1.4%, due to strong growth in aligners and CAD/CAM, partially offset by lower sales of imaging equipment, as well as a tougher comp in EDS. US CAD/CAM had a strong quarter with double-digit growth in intra oral scanners, mills and 3D printers at both the wholesale and retail level. Distributed inventory levels increased sequentially by approximately $9 million, consistent with normal seasonality. We expect US CAD/CAM distributor inventory levels to fluctuate quarter-to-quarter and be roughly flat by the end of the year compared to current levels.
Turning to Europe. Organic sales declined 5.8%, primarily due to lower essential dental solutions and equipment and instruments volume across the region. This decline was partially offset by SureSmile, which grew over 20% in the region highlighted by higher demand in Spain, France and Italy. Germany, our largest market in the region, was down double-digits versus the prior year quarter. We continue to see prolonged recessionary trends in Germany, largely affecting our equipment business. Excluding Germany, Europe organic sales declined 1.9%.
Rest of world organic sales were approximately flat in the quarter. As significant implants growth in China was offset by softer demand for equipment in Japan and Canada.
With that, let's move to slide eight to discuss our updated outlook for 2024. We're lowering our reported sales range by $50 million to reflect the additional FX headwinds due to the recent strengthening of the dollar versus the euro and other major currencies. The current FX rates, we now expect reported sales to be within the range of $3.91 billion to $3.97 billion. We are maintaining our outlook range for organic sales, which is for flat to 1.5% growth but trending to the low end of that range based on our first quarter results and the current macro environment largely impacting our imaging business.
Our current outlook assumes stronger organic sales growth in the second half of the year, primarily driven by double-digit growth in aligners, strong CAD/CAM demand, and improvements in EDS and US implants.
Moving to profitability, our outlook for adjusted EBITDA margin of greater than 18% remains unchanged from our prior guidance. Adjusted EPS is trending towards the low end of the outlook range of $2.00 to $2.10, due to the lower sales expectations. Consistent with the trends we saw in the first quarter, we expect that second quarter organic sales will decline low single digits versus the prior year period. We also expect about a $20 million headwind from foreign currency. Sequentially, reported sales are expected to increase in the second quarter based on normal seasonality. We anticipate second quarter adjusted EPS will be down slightly year-over-year, primarily due to a higher tax rate partially offset by a slight improvement in adjusted EBITDA margin.
With that, I'll now turn the call back over to Simon.