Clear Choice Holdings LLCv.Implant Direct Int’l

Trademark Trial and Appeal Board

Aug 26, 2013

No. 91190485 (T.T.A.B. Aug. 26, 2013)

THIS OPINION IS NOT A
PRECEDENT OF THE TTAB

Hearing: Mailed:
August 13, 2013 August 26, 2013

UNITED STATES PATENT AND TRADEMARK OFFICE
_____

Trademark Trial and Appeal Board
_____

Clear Choice Holdings LLC
v.
Implant Direct Int’l
_____

Opposition No. 91190485
_____

Neal G. Massand and Brian A. Colao of Dykema Gossett PLLC for Clear Choice
Holdings LLC.

Patrick F. Bright of Wagner, Anderson & Bright, P.C. for Implant Direct Int’l.
_____

Before Quinn, Gorowitz, and Hightower, Administrative Trademark Judges.

Opinion by Hightower, Administrative Trademark Judge:

On January 20, 2009, applicant Implant Direct Int’l applied to register the
mark REAL CHOICE, in standard characters, for dental implant services.1
Opposer Clear Choice Holdings LLC opposes registration on the grounds that
applicant’s mark is likely to cause confusion with its mark CLEARCHOICE

1 Application Serial Number 77652784, filed on the basis of a bona fide intention to use the
mark in commerce pursuant to Section 1(b) of the Trademark Act, 15 U.S.C. § 1051(b).
Applicant states in its brief that it is now Implant Direct Sybron International LLC (“IDS”)
and IDS now owns applicant’s mark. Applicant’s Brief at 9 n.1. However, no assignment
has been recorded.
Opposition No. 91190485

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DENTAL IMPLANTS pursuant to Section 2(d) of the Trademark Act, 15 U.S.C.
§ 1052(d), and also likely to cause dilution pursuant to Section 43(c) of the
Trademark Act, 15 U.S.C. § 1125(c). Both parties filed trial briefs, opposer filed a
reply brief, and a hearing was held on August 13, 2013.
The Record
The parties made the following evidence of record by stipulation:
• Deposition transcripts of the following fact witnesses, with exhibits:2
o Steve Boyd, manager and a founder and owner of opposer;
o Lawrence Deutsch, marketing director of opposer; and
o Dr. Gerald Alvin Niznick, president and CEO of applicant.
• Deposition transcripts of the following expert witnesses, with exhibits:
o Michael Rappeport, opposer’s survey expert, and
o Hal Poret, who prepared a critique of the Rappeport survey on
behalf of applicant.

2 The Boyd and Niznick discovery deposition transcripts may be offered in evidence at trial
because those witnesses are officers of the parties. Trademark Rule § 2.120(j)(1), 37 C.F.R.
§ 2.120(j)(1). Although no written stipulations are of record, it appears that the parties
stipulated to introduction of the discovery depositions of all other witnesses as trial
evidence. See Niznick Transcript at 112:1-12 (“Mr. Bright: One thing I do want to put on
the record . . . Mr. Colao and I have agreed, that these depositions, meaning the deposition
of ClearChoice under Rule 30(b)(6) where the witness was Mr. Boyd, Stephen Boyd, and the
testimony of Mr. Deutsch for ClearChoice and the testimony of Dr. Niznick, are both what
the Trademark Trial and Appeal Board calls discovery and evidentiary, meaning that they
can be used in the evidentiary phase of the opposition. Correct? Mr. Colao: Yes, they
can.”). This stipulation is hereby approved. See Trademark Trial and Appeal Board
Manual of Procedure (TBMP) § 704.09 (3d ed. rev. 2 June 2013). The Board also will
receive in evidence the expert deposition transcripts submitted pursuant to the parties’
joint stipulation although they were untimely filed on October 18, 2012, after the close of
trial on August 20, 2012, as Exhibits 1 and 2 to the “Joint Supplemental Notice of
Reliance.” The parties are advised that agreements to modify Board procedure should be
submitted to the Board for approval. See TBMP § 705 (“Subject to the approval of the
Board, parties may enter into a wide variety of stipulations concerning the admission of
specified matter into evidence.”).
Opposition No. 91190485

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All transcripts were introduced by notice of reliance. The parties are advised that
otherwise admissible deposition transcripts are not admissible via notice of reliance
but instead should be individually filed with the Board pursuant to the procedure
identified in Trademark Rule § 2.125, 37 C.F.R. § 2.125.
The following additional evidence was made of record via notice of reliance:
• A status and title copy of opposer’s pleaded Registration Number
3225921, as well as a certified copy of its file history;3
• The file history of the opposed application, Serial Number 77652784;4
• The following discovery documents:
o Opposer’s initial disclosures;
o Opposer’s response to applicant’s interrogatories;
o Opposer’s response to applicant’s request for production of
documents;
o Opposer’s first amended response to applicant’s interrogatories;
o Applicant’s responses to opposer’s interrogatories;
o Applicant’s responses to opposer’s requests for production of
documents;

3 Opposer also attempted to introduce copies of its other three pleaded registrations –
Nos. 3553219, 3685880, and 3181966 – as Exhibit 3 to the “Joint Supplemental Notice of
Reliance.” However, opposer provided only plain copies of the registration certificates,
which do not establish current status and title of the registrations. Pursuant to Trademark
Rule § 2.122(d), this was not effective to make these registrations of record, and they are
not in evidence. Furthermore, we take judicial notice of the fact that Registration
No. 3181966 was cancelled July 12, 2013 pursuant to Section 8 of the Trademark Act. See
Nike Inc. v. WNBA Enters. LLC, 85 USPQ2d 1187, 1193 n.9 (TTAB 2007); Black & Decker
Corp. v. Emerson Elec. Co., 84 USPQ2d 1482, 1487-88 n.10-12 (TTAB 2007); TBMP
§ 704.03(b)(1)(A).
4 It was unnecessary to submit the file history of the opposed application, as it forms part of
the record of the proceeding without any action by the parties. Trademark Rule
§ 2.122(b)(1); TBMP § 704.03(a). For the same reason, it also was unnecessary to submit
the pleadings in the case by notice of reliance.
Opposition No. 91190485

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o Applicant’s supplemental responses to opposer’s interrogatories;
o Opposer’s survey report, prepared by Michael Rappeport of RL
Associates, and verbatim survey responses;
o Expert report of Hal Poret, an analysis of opposer’s survey
prepared for applicant; and
o A series of letters and emails exchanged between opposer’s
counsel and applicant’s principal.
All of these documents were proffered by opposer via notice of reliance.
It was improper for opposer to submit its own discovery responses.
Trademark § 2.120(j)(5); Trademark Trial and Appeal Board Manual of Procedure
(TBMP) § 704.10 (3d ed. rev. 2 June 2013). Additionally, letters, emails, and expert
reports are not admissible by notice of reliance. Trademark Rule 2.122(e); TBMP
§ 704.08(a). However, applicant did not object to admission of any of these
materials; in fact, applicant affirmatively incorporated by reference each of the
documents submitted by opposer in its own notice of reliance. For these reasons, we
hereby admit into evidence all the materials listed above for whatever persuasive
value they may have.5
Finally, we take judicial notice of the excerpt from THE SYNONYM FINDER
attached as Exhibit A to opposer’s reply brief. We also take judicial notice of the
following definitions of the adjectives “clear” and “real” on the Merriam-Webster
Online Dictionary (m-w.com), referenced in applicant’s brief, as available on the
date of the oral hearing:

5 We note that several of the documents also appear in the record as deposition exhibits.
Opposition No. 91190485

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Definition of CLEAR
1 a : BRIGHT, LUMINOUS
b : CLOUDLESS; specifically : less than one-tenth covered

c : free from mist, haze, or dust
d : UNTROUBLED, SERENE
2 : CLEAN, PURE: as
a : free from blemishes
b : easily seen through : TRANSPARENT
c : free from abnormal sounds on auscultation
3 a : easily heard
b : easily visible : PLAIN
c : free from obscurity or ambiguity : easily understood :
UNMISTAKABLE
4 a : capable of sharp discernment : KEEN
b : free from doubt : SURE
5 : free from guile or guilt : INNOCENT
6 : unhampered by restriction or limitation: as
a : unencumbered by debts or charges
b : NET
c : UNQUALIFIED, ABSOLUTE
d : free from obstruction
e : emptied of contents or cargo
f : free from entanglement or contact
g : BARE, DENUDED

Definition of REAL
1 : of or relating to fixed, permanent, or immovable
things (as lands or tenements)
2 a : not artificial, fraudulent, or illusory : GENUINE ; also : being precisely what the name implies
b (1) : occurring or existing in actuality (2) : of or relating to
practical or everyday concerns or activities (3) : existing as a physical
entity and having properties that deviate from an ideal,
law, or standard — compare IDEAL 3b
c : having objective independent existence
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d : FUNDAMENTAL, ESSENTIAL
e (1) : belonging to or having elements or components
that belong to the set of real numbers (2) : concerned with or
containing real numbers (3) : REAL-
VALUED
f : measured by purchasing power
g : COMPLETE, UTTER
3 of a particle : capable of being detected — compare
VIRTUAL 3

See UMG Recordings Inc. v. Mattel, Inc., 100 USPQ2d 1868, 1874 (TTAB 2011);
FED. R. EVID. 201(c)(1), (2); TBMP § 704.12.
Standing and Priority
We first consider opposer’s standing to bring this opposition against the
involved application. Opposer has established its ownership of pleaded Registration
No. 3225921, issued April 3, 2007 for the mark CLEARCHOICE DENTAL
IMPLANTS for “dental services, namely dental implant services.” Opposer’s
standing to oppose registration of applicant’s mark is established by its pleaded
registration, which the record shows to be valid and subsisting, and owned by
opposer. See Cunningham v. Laser Golf Corp., 222 F.3d 943, 55 USPQ2d 1842,
1844 (Fed. Cir. 2000). In addition, because opposer’s pleaded registration is of
record, priority is not in issue with respect to the services identified in the
registration, namely dental implant services. Penguin Books Ltd. v. Eberhard, 48
USPQ2d 1280, 1286 (TTAB 1998) (citing King Candy Co. v. Eunice King’s Kitchen,
Inc., 496 F.2d 1400, 182 USPQ 108, 110 (CCPA 1974)). There is no dispute that
opposer has priority vis-à-vis applicant, which filed the involved application on an
intent-to-use basis on January 20, 2009.
Opposition No. 91190485

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Likelihood of Confusion
“We determine likelihood of confusion by focusing on the question whether
the purchasing public would mistakenly assume that the applicant’s [services]
originate from the same source as, or are associated with, the [services] in the cited
registrations.” In re Majestic Distilling Co., 315 F.3d 1311, 65 USPQ2d 1201, 1203
(Fed. Cir. 2003). We consider all probative facts in evidence that are relevant to the
likelihood of confusion factors set forth in In re E.I. du Pont de Nemours & Co., 476
F.2d 1357, 177 USPQ 563, 567 (CCPA 1973).
The parties have presented evidence on the following du Pont factors:
similarity of the parties’ marks (factor 1); similarity of their services (factor 2);
similarity of trade channels and the buyers to whom sales are made, including
consumer sophistication (factors 3 and 4); fame of opposer’s mark (factor 5); the
nature and extent of any actual confusion (factor 7); and the length of time during
and conditions under which there has been concurrent use without evidence of
actual confusion (factor 8). Opposer also has submitted evidence concerning
applicant’s alleged bad-faith intent in adopting its mark (du Pont factor 13; see also,
e.g., M2 Software, Inc. v. M2 Commc’ns, Inc., 450 F.3d 1378, 78 USPQ2d 1944, 1947
(Fed. Cir. 2006)). We find the remaining factors to be neutral or inapplicable.
A. Similarity of the Services, Channels of Trade, and Classes of Customers
We begin with the similarities or differences between opposer’s and
applicant’s services, the second du Pont factor. It is settled that in making our
determination regarding the relatedness of the parties’ services, we must look to the
services as identified in the application and opposer’s pleaded registration. See
Opposition No. 91190485

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Octocom Sys. Inc. v. Houston Computer Servs. Inc., 918 F.2d 937, 16 USPQ2d 1783,
1787 (Fed. Cir. 1990). That is, because the scope of the registration applicant seeks
is defined by its application (not by its use), it is the application (not its use) that we
must look to in determining applicant’s right to register:
The authority is legion that the question of registrability
of an applicant’s mark must be decided on the basis of the
identification of goods set forth in the application
regardless of what the record may reveal as to the
particular nature of an applicant’s goods, the particular
channels of trade or the class of purchasers to which sales
of the goods are directed.
Id.
The services identified in opposer’s Registration No. 3225921 for
CLEARCHOICE DENTAL IMPLANTS are “dental services, namely dental implant
services.” The services identified in the application likewise are “dental implant
services.” Thus, the parties’ services are identical.
The third du Pont factor assesses the similarity of the trade channels for the
parties’ services. Because there are no limitations to the recitation of services in the
application or opposer’s registration as to channels of trade and classes of
purchasers, we must presume that the parties’ services travel through all usual
channels of trade and are offered to all normal potential purchasers. See Citigroup
Inc. v. Capital City Bank Group, Inc., 637 F.3d 1344, 98 USPQ2d 1253, 1261
(Fed. Cir. 2011); In re Jump Designs LLC, 80 USPQ2d 1370, 1374 (TTAB 2006); see
also Paula Payne Prods. Co. v. Johnson Publ’g Co., 473 F.2d 901, 177 USPQ 76, 77
(CCPA 1973). Moreover, because the services described in the application and
opposer’s registration are identical, we presume that the channels of trade and
Opposition No. 91190485

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classes of purchasers are the same. See In re Viterra Inc., 671 F.3d 1358, 101
USPQ2d 1905, 1908 (Fed. Cir. 2012) (finding Board entitled to rely on this legal
presumption in determining likelihood of confusion); American Lebanese Syrian
Assoc. Charities Inc. v. Child Health Research Inst., 101 USPQ2d 1022, 1028 (TTAB
2011).
The second and third du Pont factors weigh heavily in opposer’s favor.
B. Similarity of the Marks
We next address the du Pont likelihood of confusion factor focusing on the
similarity or dissimilarity of “‘the marks in their entireties as to appearance, sound,
connotation, and commercial impression.’” Palm Bay Imps. Inc. v. Veuve Clicquot
Ponsardin Maison Fondee En 1772, 396 F.3d 1369, 73 USPQ2d 1689, 1691 (Fed.
Cir. 2005) (quoting du Pont, 177 USPQ at 567). In comparing the marks, we are
mindful that the test is not whether the marks can be distinguished when subjected
to a side-by-side comparison, but rather whether they are sufficiently similar in
terms of their overall commercial impression so that confusion as to the source of
the services offered under the respective marks is likely to result. San Fernando
Elec. Mfg. Co. v. JFD Elecs. Components Corp., 565 F.2d 683, 196 USPQ 1, 3 (CCPA
1977); Spoons Rests. Inc. v. Morrison Inc., 23 USPQ2d 1735, 1741 (TTAB 1991),
aff’d, No. 92-1086 (Fed. Cir. June 5, 1992).
Because the similarity or dissimilarity of the marks is determined based on
the marks in their entireties, our analysis cannot be predicated on dissecting the
marks into their various components; that is, the decision must be based on the
entire marks, not just part of the marks. In re Nat’l Data Corp., 753 F.2d 1056, 224
Opposition No. 91190485

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USPQ 749, 751 (Fed. Cir. 1985); see also Franklin Mint Corp. v. Master Mfg. Co.,
667 F.2d 1005, 212 USPQ 233, 234 (CCPA 1981) (“It is axiomatic that a mark
should not be dissected and considered piecemeal; rather, it must be considered as a
whole in determining likelihood of confusion.”). On the other hand, different
features may be analyzed to determine whether the marks are similar. Price Candy
Co. v. Gold Medal Candy Corp., 220 F.2d 759, 105 USPQ 266, 268 (CCPA 1955). In
fact, there is nothing improper in stating that, for rational reasons, more or less
weight has been given to a particular feature of a mark, provided the ultimate
conclusion rests on a consideration of the marks in their entireties. In re Nat’l Data
Corp., 224 USPQ at 751.
Where, as here, the services are identical, the degree of similarity between
the marks necessary to find likelihood of confusion need not be as great as where
there is a recognizable disparity between the services. See Century 21 Real Estate
Corp. v. Century Life of America, 970 F.2d 874, 23 USPQ2d 1698, 1700 (Fed. Cir.
1992); Jansen Enters. Inc. v. Rind, 85 USPQ2d 1104, 1108 (TTAB 2007).
The mark applicant seeks to register is REAL CHOICE. Opposer’s registered
mark is CLEARCHOICE DENTAL IMPLANTS, with DENTAL IMPLANTS – the
generic term for both parties’ identified services – disclaimed. It is well-settled that
disclaimed, descriptive matter may have less significance in likelihood of confusion
determinations. See Cunningham v. Laser Golf Corp., 55 USPQ2d at 1846
(“Regarding descriptive terms, this court has noted that the ‘descriptive component
of a mark may be given little weight in reaching a conclusion on the likelihood of
Opposition No. 91190485

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confusion.’”) (quoting In re Nat’l Data Corp., 224 USPQ at 752); In re Code
Consultants, Inc., 60 USPQ2d 1699, 1702 (TTAB 2001) (disclaimed matter is often
“less significant in creating the mark’s commercial impression”). Thus, though we
compare the marks REAL CHOICE and CLEARCHOICE DENTAL IMPLANTS in
their entireties, we give more weight to the distinctive portions of the two marks:
REAL CHOICE and CLEARCHOICE.
The absence of a space between the words CLEAR and CHOICE in opposer’s
registration does not significantly impact the commercial impression made by its
mark, as consumers are still likely to recognize the individual component words
CLEAR and CHOICE. In appearance and sound, REAL CHOICE and
CLEARCHOICE are similar; each prefaces the word CHOICE with a one-syllable
term featuring a long “e” vowel sound framed by consonants. Indeed, REAL is an
anagram of CLEAR minus the “c.”
Applicant disputes opposer’s contention that CLEAR and REAL have similar
meanings. Nonetheless, opposer provided a thesaurus listing “real” as one of many
synonyms for the adjective “clear.”6 Although we do not view the phrases REAL
CHOICE and CLEARCHOICE as exact synonyms, their connotations are related.
Overall, applicant’s REAL CHOICE mark makes a commercial impression
similar to opposer’s registered mark CLEARCHOICE DENTAL IMPLANTS,
particularly considered in the context of the parties’ identical identified services.
The first du Pont factor weighs in opposer’s favor.

6 J.I. RODALE, THE SYNONYM FINDER 174 (1978), Opposer’s Reply Brief, Exhibit A.
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C. Conditions of Sale and Consumer Sophistication
Under the fourth du Pont factor, we consider the conditions under which and
buyers to whom sales are made. The evidence shows that dental implant services
can be very expensive, costing from $10,000 to $50,000.7 We are constrained,
however, to consider the parties’ “dental implant services” as they are recited in the
application and registration, which are not limited to services of any certain price.
Moreover, there is no evidence establishing that purchasers of dental implants are
sophisticated.8 The Board has previously noted that, “in purchasing healthcare
services, even ordinary consumers are likely to exercise greater care and will know
with whom they are dealing.” Carefirst of Md., Inc. v. FirstHealth of the Carolinas
Inc., 77 USPQ2d 1492, 1504 (TTAB 2005). Yet even assuming that ordinary
consumers tend to exercise some sophistication when purchasing healthcare
services, careful or sophisticated purchasers are not immune from source confusion
where similar marks are used in connection with related services. See In re
Research & Trading Corp., 793 F.2d 1276, 230 USPQ 49, 50 (Fed. Cir. 1986)
(“‘Human memories even of discriminating purchasers . . . are not infallible.’”)
(quoting Carlisle Chem. Works, Inc. v. Hardman & Holden Ltd., 434 F.2d 1403, 168
USPQ 110, 112 (CCPA 1970)).
We find that the similarities between the marks and the goods sold
thereunder outweigh any sophisticated purchasing decision. See HRL Assocs. Inc.

7 Boyd Transcript at 36:7-10, 84:5-20.
8 Opposer’s manager Steve Boyd testified that both parties offer their services to “[a]nybody
who is missing one, several or all of their teeth or needs to have their bad teeth replaced.”
Id. at 115:16-18.
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v. Weiss Assocs. Inc., 12 USPQ2d 1819, 1823 (TTAB 1989), aff’d, Weiss Assocs., Inc.
v. HRL Assocs., Inc., 902 F.2d 1546, 14 USPQ2d 1840 (Fed. Cir. 1990) (similarities
of goods and marks outweigh sophisticated purchasers, careful purchasing decision,
and expensive goods). Thus, the fourth du Pont factor is neutral.
D. Fame of Opposer’s Mark
The fifth du Pont factor requires us to consider the fame of opposer’s marks.
Fame, if it exists, plays a dominant role in the likelihood of confusion analysis
because famous marks enjoy a broad scope of protection or exclusivity of use. A
famous mark has extensive public recognition and renown. Bose Corp. v. QSC
Audio Prods. Inc., 293 F.3d 1367, 63 USPQ2d 1303, 1305 (Fed. Cir. 2002).
Fame may be measured indirectly by the volume of sales and advertising
expenditures of the services identified by the marks at issue, “the length of time
those indicia of commercial awareness have been evident,” widespread critical
assessments and notice by independent sources of the services identified by the
marks, and by the general reputation of the services. Id., 63 USPQ2d at 1305-09.
Some context in which to place raw numbers of product sales and advertising
expenses may be necessary (e.g., the substantiality of the sales or advertising
figures for comparable types of products or services). Id. at 1309. Finally, because
of the extreme deference that we accord a famous mark in terms of the wide
latitude of legal protection it receives, and the dominant role fame plays in the
likelihood of confusion analysis, it is the duty of the party asserting that its mark is
famous to clearly prove it. Leading Jewelers Guild Inc. v. LJOW Holdings LLC, 82
USPQ2d 1901, 1904 (TTAB 2007).
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Opposer’s evidence falls woefully short of establishing the fame of its mark.
Opposer provides only scant, indirect evidence of fame in the form of testimony that
it currently has 32 centers in 21 geographic marketplaces nationwide;9 that it has
treated “thousands” of customers;10 and that its centers spend $1 million per month
advertising its services.11 Conspicuous in its absence is any evidence, whether
direct or indirect, that opposer’s efforts to publicize its mark have succeeded in
garnering consumer or third-party recognition of its mark. Applicant provides no
evidence as to its sales or share of the dental implant services market, no detail as
to how many “thousands” of customers it has treated nationwide, no evidence as to
the time frame during which it has spent $1 million per month on advertising,12 and
little specific evidence by which we could determine the forms of opposer’s

9 Deutsch Transcript at 16:5-8.
10 Id. at 31:5-32:10.
11 Boyd Transcript at 118:20-119:7. Applicant argues in its brief that testimony by
Mr. Boyd regarding opposer’s advertising expenditures is inadmissible because he lacked
personal knowledge under FED. R. EVID. 602. We note that applicant’s counsel did not
object to this testimony at deposition. We also disagree with applicant’s argument because,
not only was Mr. Boyd designated as opposer’s corporate representative, he also testified
that he had personal knowledge of this subject. Boyd Transcript at 118:20-119:2.
Applicant also objects that evidence of opposer’s advertising expenditures should have come
from original documents pursuant to FED. R. EVID. 1002. See Applicant’s Brief at 22-23. In
this case, any written evidence of advertising expenditures would fall under FED. R. EVID.
1004(d), an exception to the “best evidence rule” embodied in Rule 1002, because such
documents are “not closely related to a controlling issue.” See Mag Instrument, Inc. v.
Brinkmann Corp., 96 USPQ2d 1701, 1707-08 (TTAB 2010), aff’d, No. 2011-1052, -1053
(Fed. Cir. Nov. 9, 2011). Thus, we see no reason to exclude Mr. Boyd’s oral testimony. In
any event, should admission of Mr. Boyd’s testimony be held erroneous on appeal, the error
is harmless because opposer’s advertising expenditures are insufficient to prove fame and
do not affect our finding on du Pont factor 5 or our holding herein.
12 There is no record support for opposer’s assertion in its brief that opposer has spent a
total of nearly $84 million on advertising. Opposer’s Brief at 17. Presumably, this figure
was derived simply by multiplying $1 million by the number of months opposer has been in
existence. No witness testified that opposer has spent $1 million in advertising each month
since it began doing business, and such a conclusion is unsupported by any record evidence.
Opposition No. 91190485

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advertising and how that advertising uses opposer’s mark.13 Because opposer has
not proven that its mark is famous, the fifth du Pont factor is neutral.
E. Extent of Concurrent Use and Actual Confusion
Among the final relevant du Pont factors, factor 7 assesses the nature and
extent of any actual confusion, while factor 8 is the length of time during and
conditions under which there has been concurrent use without evidence of actual
confusion.
Proof of actual confusion is not necessary to show a likelihood of confusion,
and its absence is not dispositive. See Giant Food, Inc. v. Nation’s Foodservice, Inc.,
710 F.2d 1565, 218 USPQ 390, 396 (Fed. Cir. 1983). A showing of actual confusion
would of course be highly probative, if not conclusive, of a likelihood of confusion.
Yet the opposite is not true; the lack of evidence of actual confusion carries little
weight. See J. C. Hall Co. v. Hallmark Cards, Inc., 340 F.2d 960, 144 USPQ 435,
438 (CCPA 1965).
The parties had coexisted for approximately 4½ years at the time of the oral
hearing, since applicant first used the REAL CHOICE mark in February 2009,
without evidence of actual confusion.14 However, applicant contends, and opposer

13 See, e.g., Boyd Transcript at 81:7-12 (stating that opposer advertises via television,
newspaper, radio, billboards, magazines, direct mail, and the Internet), 104:15-105:5
(stating that some of opposer’s ads feature celebrities Mike Ditka and Tony Curtis), and
Exhibit 4-23 (2009 newspaper ad for opposer featuring Mike Ditka). Although 85% of the
respondents to opposer’s survey – which will be discussed further infra – said they had
heard of ClearChoice, we give this result no weight in our fame analysis because the survey
universe was selected from a list of individuals who opposer said had contacted it within
the preceding three years, presumably all of whom should be familiar with opposer.
14 See Boyd Transcript at 10:16-18; Niznick Transcript at 27:5-9; Exhibits 20 and 22,
applicant’s response to opposer’s interrogatory No. 4.
Opposition No. 91190485

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does not dispute, that there are only three markets where both marks are in use:
Atlanta, San Francisco, and Washington, D.C.,15 limiting the opportunities for
actual confusion to arise. Du Pont factor 8 is therefore neutral.
Opposer submitted a survey, which can be regarded as evidence of actual
confusion. See Blue Cross & Blue Shield Ass’n v. Harvard Cmty. Health Plan Inc.,
17 USPQ2d 1075, 1078 n.7 (TTAB 1990). However, while we will not address and
do not necessarily accept all the critiques of that survey in the analysis by
applicant’s expert Hal Poret, the survey still suffers from numerous serious flaws.
First and foremost, the survey did not follow an established format to
measure likelihood of confusion, but was created by opposer’s expert in a design
never before used in a trademark survey or accepted by any court.16 The survey
combined tests of applicant’s mark REAL CHOICE and a different third-party mark
opposer is challenging (represented as RIGHT CHOICE),17 an approach the Poret
analysis criticized. It also used a small number of respondents to test each mark:
90. Mr. Poret pointed out that smaller samples produce larger error rates, and we
have found similar numbers of survey respondents insufficient. See Zimmerman v.
Nat’l Ass’n of Realtors, 70 USPQ2d 1425, 1436 (TTAB 2004) (96 survey subjects too
low); In re Kimpton Hotel & Rest. Group, Inc., 55 USPQ2d 1154, 1157 (TTAB 2000)
(100 respondents insufficient).

15 Applicant’s Brief at 14. How long the parties’ services have overlapped in these markets
is unknown.
16 See Rappeport Transcript at 62:23-65:17.
17 The Rappeport survey report (“Rappeport Report”) states that the name RightChoice is
used by a dental practice in New York City that offers dental implantation. Id. at 1.
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In addition, rather than following the accepted approach of using a survey
universe comprising potential consumers of applicant’s dental implant services,18
opposer’s survey was conducted among a sample of 150,000 customers who had
contacted opposer within the preceding three years and did not live in the 19
markets19 where applicant offers its services. Thus, the survey universe was
purposely selected to be aware of opposer20 and not applicant.21 Moreover,
respondents were asked only whether they were familiar with dental implants, not
if they were prospective consumers of dental implants.22
The survey was designed, in relevant part, to test the hypothesis that:
“When potential consumers who are aware of ClearChoice encounter the name
RealChoice used in the context of dental implant services, they are likely to confuse
it with ClearChoice.”23 During the survey, respondents were told that the

18 6 J. THOMAS MCCARTHY, MCCARTHY ON TRADEMARKS & UNFAIR Competition § 32:159
(4th ed. 2013) (“In a traditional case claiming ‘forward’ confusion, not ‘reverse’ confusion,
the proper universe to survey is the potential buyers of the junior user’s goods or services.
. . . A survey of the wrong ‘universe’ will be of little probative value in litigation.”).
19 See Exhibit 22, attachment to applicant’s supplemental responses to opposer’s
interrogatories.
20 The Poret analysis raises questions as to whether this assumption underlying the survey
hypothesis and design was borne out by the results. Some 15% of the 180 total survey
respondents said that they had never heard of CLEAR CHOICE, while another 38% said
they had never had contact with CLEAR CHOICE, for a total of 53% – more than half.
21 See Rappeport Transcript at 34:9-13 (answering that survey respondents were from
“places RealChoice was not available. That’s the whole point.”). Surveys in which the
target population was consumers of the plaintiff’s product have been criticized for not
studying the full range of potential customers. See Shari Seidman Diamond, Reference
Guide on Survey Research, in REFERENCE MANUAL ON SCIENTIFIC EVIDENCE 359, 379
(3d ed. 2011).
22 Questionnaire, Appendix A to Rappeport Report, at 1.
23 Rappeport Report at 2.
Opposition No. 91190485

18

interviewer would read them the names of companies that provide dental implant
services, and asked whether they had heard of the two marks at issue here; 45
heard CLEAR CHOICE first followed by REAL CHOICE, while the other 45 heard
the marks in reverse order. Respondents were also asked about the control name
RIGHT OPTION during the portion of the survey relevant here. The results were:
• 86% of the 90 respondents said they had heard of CLEAR CHOICE,
13% had not heard of it, and 1% were not sure;
• 27% of the 45 respondents [i.e., 12 people] who heard REAL CHOICE
before CLEAR CHOICE said they had heard of REAL CHOICE while
73% had not heard of it;
• 4% of the 45 respondents [i.e., 2 people] who heard REAL CHOICE
after CLEAR CHOICE said they had heard of it, 96% had not heard of
it; and
• 3% of the 90 respondents said they had heard of the control name
RIGHT OPTION and 97% had not heard of it.24
The survey then combined “the estimates of guessing and prior actual
contact” with both names tested, REAL CHOICE and RIGHT CHOICE, to increase
statistical reliability of what the survey author considered to be noise, arriving at a
figure of 6%. This 6% “estimate of the guessing/prior contact” was subtracted from
the 27% result to yield a 21% result for the name REAL CHOICE. In a second
measure of noise, the survey again combined respondents who said they had heard
of the controls across both names tested to arrive at a 4% estimate of noise, yielding
a 23% result for the name REAL CHOICE.
In sum, 21% to 23% more survey respondents said they had heard of CLEAR
CHOICE and not REAL CHOICE when questioned about the terms in that order

24 Id. at 9.
Opposition No. 91190485

19

than when asked with the terms in reverse order. Opposer’s expert contends that
this result shows confusion in those percentages; that is, that 21% to 23% of
potential consumers who are aware of CLEAR CHOICE and encounter the name
REAL CHOICE in the context of dental implant services are likely to confuse it
with CLEAR CHOICE.25
Survey respondents also were asked follow-up questions:
Q1a. What, if anything, can you tell me about [INSERT
NAME], aside from the fact that they provide
dental implant services?
Q1b. By any chance, have you or has anyone in your
household ever had any contact with [INSERT
NAME]?
Those respondents who said they or someone in their household had contact
with the company were asked:
Q1c. By any chance, have you or has anyone in your
household ever had any work done by [INSERT
NAME]?
However, opposer’s expert report does not address the responses to these follow-up
questions, and they apparently were not factored into the survey results.
Mr. Poret contends in his analysis that, among the 24 respondents who were
asked about REAL CHOICE or RIGHT CHOICE before CLEAR CHOICE and
answered that they had heard of REAL CHOICE or RIGHT CHOICE, 16
respondents gave additional answers indicating that they were not confused by the
test names. Mr. Poret states that four subjects said they had not heard of CLEAR
CHOICE, so they could not be experiencing source or trademark confusion between

25 Id. at 12.
Opposition No. 91190485

20

the parties. According to Mr. Poret, 12 other subjects gave responses suggesting
that they recognize the parties here (or the user of the RIGHT CHOICE mark) as
separate entities and were not confused.26 Mr. Poret argues that this leaves only 8
out of 90 respondents who possibly could have been confused, that is, less than 9%
of respondents before accounting for survey noise and margin of error.
Given that opposer characterizes its mark as famous, we question why
opposer’s expert chose not to follow the Ever-Ready27 survey format, which we have
accepted and which has been called the “gold standard” in likelihood of confusion
cases.28 6 J. THOMAS MCCARTHY, MCCARTHY ON TRADEMARKS & UNFAIR
COMPETITION § 32:173.50 (4th ed. 2013) (quoting J.B. Swann, Likelihood of
Confusion Studies and the Straightened Scope of Squirt, 98 TRADEMARK REP. 739,
746 (2008)); see also Starbucks U.S. Brands, LLC v. Ruben, 78 USPQ2d 1741, 1753
(TTAB 2006) (stating “given the way in which this survey format carefully follows
the Ever-Ready likelihood of confusion survey format, we find that it is reliable and
therefore of probative value on the issue of likelihood of confusion herein”).

26 According to Mr. Poret, these 12 individuals said during the survey that they had
contacted one but not the other of the parties (or RIGHT CHOICE), indicating that they
understood them to be distinct sources.
27 Union Carbide Corp. v. Ever-Ready, Inc., 531 F.2d 366, 188 USPQ 623 (7th Cir. 1976). In
that case, plaintiff Union Carbide conducted a survey to determine whether there was a
likelihood of confusion between defendant’s EVER-READY lamps and plaintiff’s
EVEREADY batteries, flashlights and bulbs. The survey asked: “Who do you think puts
out the lamp shown here? [showing a picture of defendant’s EVER-READY lamp and
mark],” “What makes you think so?” and “Please name any other products put out by the
same concern which puts out the lamp shown here.” Id. at 640.
28 Opposer’s expert testified that he designed the survey to test initial interest confusion.
See Rappeport Transcript at 37-39. Our primary reviewing court has not embraced the
theory of initial confusion. Weiss Assocs., Inc. v. HRL Assocs., Inc., 902 F.2d 1546, 14
USPQ2d 1840, 1842-43 (Fed. Cir. 1990).
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21

Because we cannot conclude that opposer’s survey actually measured an
appreciable likelihood of confusion, we give it no weight in our analysis. See In re
Hotels.com, L.P., 87 USPQ2d 1100, 1109-10 (TTAB 2008), aff’d, In re Hotels.com LP,
573 F3d 1300, 91 USPQ2d 1532 (Fed. Cir. 2009). Du Pont factor 7 is neutral.
F. Applicant’s Intent
Finally, opposer emphasizes that applicant initially adopted a logo that was
virtually identical to opposer’s logo, including incorporating the same shooting star
design, and that applicant copied elements of opposer’s website. In response,
applicant’s CEO, Dr. Niznick, did not deny that applicant initially used a logo
incorporating a shooting star in the same manner as opposer’s logo, but emphasized
that it was changed promptly after opposer objected. Dr. Niznick testified:
. . . I told my IT people, “We want to put together a Web
site that we could offer to doctors,” and I referred them to
the ClearChoice Web site as an example of the kind of
patient information that we would need, just like I look at
[dental implant maker] Nobel’s Web site or anybody
else’s. This is what they came up with.
As soon as your client contacted us and objected to
it, I immediately changed and responded and went to
something that is very distinct from – in the look,
eliminating the star, putting an implant in, different color
background, different font.29

Bad faith, or intent to confuse, falls under the thirteenth du Pont factor, “any
other established fact probative of the effect of use.” L.C. Licensing Inc. v. Berman,
86 USPQ2d 1883, 1890 (TTAB 2008). “[A] party which knowingly adopts a mark
similar to one used by another for related goods should not be surprised to find

29 Niznick Transcript at 27:16-28:1.
Opposition No. 91190485

22

scrutiny of the filer’s motive.” L’Oreal S.A. v. Marcon, 102 USPQ2d 1434, 1442
(TTAB 2012). “[W]here there is evidence of an applicant’s intent to adopt a mark
that suggests to purchasers a successful mark already in use by another, the Board
may, and ought to, take into account that intent when resolving the issue of
likelihood of confusion when that issue is not free from doubt.” First Int’l Servs.
Corp. v. Chuckles Inc., 5 USPQ2d 1628, 1633 (TTAB 1988). However, “an inference
of ‘bad faith’ requires something more than mere knowledge of a prior similar
mark.” Sweats Fashions, Inc. v. Pannill Knitting Co., 833 F.2d 1560, 4 USPQ2d
1793, 1798 (Fed. Cir. 1987). A finding of bad faith must be supported by evidence of
an intent to confuse, rather than mere knowledge of another’s mark or even an
intent to copy. See, e.g., Starbucks Corp. v. Wolfe’s Borough Coffee, Inc., 588 F.3d
97, 92 USPQ2d 1769, 1782 (2d Cir. 2009) (“[T]he only relevant intent is intent to
confuse. There is a considerable difference between an intent to copy and an intent
to deceive.”) (quotation omitted).
In light of applicant’s change to its logo after contact by opposer, we cannot
conclude that applicant manifested a bad-faith intent to deceive consumers, even if
it did intend to copy opposer’s logo and website. We therefore find the final
likelihood of confusion factor to be neutral.
Weighing the Factors
We have carefully considered all of the record evidence pertaining to the
relevant du Pont factors, as well as the parties’ arguments with respect thereto
(including any evidence and arguments not specifically discussed in this opinion).
All relevant factors either favor opposer or are neutral. On balance, we find by a
Opposition No. 91190485

23

preponderance of the evidence that applicant’s REAL CHOICE mark is likely to
cause confusion with opposer’s mark CLEARCHOICE DENTAL IMPLANTS when
used in association with dental implant services. To the extent we have any doubt,
it must be resolved in favor of the prior registrant. Nike Inc. v. WNBA Enters. LLC,
85 USPQ2d at 1202; Hard Rock Cafe Int’l (USA) Inc. v. Elsea, 56 USPQ2d 1504,
1514 (TTAB 2000).
Likelihood of Dilution by Blurring
We conclude by briefly addressing opposer’s claim that applicant’s mark will
dilute its mark under Trademark Act § 43(c), 15 U.S.C. § 1125(c), by blurring its
distinctiveness. To prevail on a dilution claim, opposer must prove that: (1) its
mark is famous, (2) its mark became famous prior to the date of the application to
register the applicant’s mark, and (3) applicant’s mark is likely to blur the
distinctiveness of the opposer’s famous mark. Nike, Inc. v. Maher, 100 USPQ2d
1018, 1023 (TTAB 2011).
Dilution requires a more stringent showing of fame than likelihood of
confusion. Coach Servs. Inc. v. Triumph Learning LLC, 668 F.3d 1356, 101
USPQ2d 1713, 1724 (Fed. Cir. 2012). For all the same reasons we have determined
that opposer has not met its burden to prove that its mark is famous for purposes of
likelihood of confusion, opposer has not met its higher burden to prove fame in the
dilution context, and its dilution claim must fail. See id. at 1727.
Decision: The opposition is sustained on the ground of likelihood of confusion
pursuant to Section 2(d) of the Trademark Act and dismissed as to likelihood of
dilution under Trademark Act Section 43(c).