## 3 Results and Discussion
The calculation and analysis results exhibited that the state of stress altered from compressive stress to tensile stress at the PAT film and the bone cell layer boundary, as shown in Figure 5. Based on the stress variation analysis, the bone cell reacted with the thin film containing stress flow resulted in the formation of defects (voids, dislocation, and slips). As discovered in all specimens, bone cells causing the stress formation seem to be large enough to induce the mechanical failure of the biosensing capacitor with microvoids. Similar results have been observed in previous studies [11; 14]. It is well known that surface atoms are usually bonded to internal atoms through chemical bonding. If surface atoms are to be released, the bonds to internal atoms must be broken. Surface activation energy is often required to break these bonds. During cell differentiation and proliferation, the equivalent activation energy formed by a mechanobiological reaction happens to endure the surface activation energy of the PAT film. The equivalent activation energy generated from cell differentiation and proliferation is named as the cell activation energy (CAE). In the mechanobiological reaction, the CAE is the redox potential in the mechanobiological reaction of MG-63 cells and NIH3T3 cells in a multilayered PAT film. The lattice defects and/or initial stress of PAT film have all been found to affect the cell differentiation and proliferation. Moreover, the surface activation energy was reduced as the grain boundaries and sub-grain boundaries of the PAT film increased. The nanopolycrystalline {002} PAT film is preferred and reacts faster than the {111} planes, forming a mechanobiological reaction. Thus, the mechanobiological reaction of cell differentiation and proliferation not only causes osseeo/osteointegration, but also decreases the surface activation energy, then enhancing bone remodeling. The formation of a nanopolycrystalline {002} PAT film is believed to promote biocompatibility, enhancing osseointegration. Therefore, the mechanobiological formation of PAT on a Ti implant with and without cell differentiation and proliferation must be discussed at length. Furthermore, the adhesion, morphology, and proliferation of MG-63 cells on the surface of the PAT film led to the following results: first, the cells exhibited a higher thickness, and a nanometer-scale roughness favored the formation of longer and more filopodia than that of the NIH3T3 cell. The MG-63 cells and NIH3T3 cells responded to the PAT surface topography with adhesion, altered morphology, and proliferation. Additionally, an excellent biosensing and a biocompatible film should offer a superior surface topography that allows for rapid bone healing. In the stress analysis results, the PAT film was capable of enhancing more differentiation and proliferation of MG-63 cells than that of NIH3T3 cells over the same period of time. This revealed that the enhancement of the proliferation capability of MG-63 bone cells can enhance osseointegration and re-osseointegration. In addition, it is also an important factor in the postoperative healing and bone remodeling of cortical bone [25]. The biosensing effect of the biomechanical reaction on an osseointegrated implant with PAT film was evaluated efficiently using a biosensing capacitor and a representation of the implant-to-bone and stress-transfer performances. Therefore, the PAT film could potentially be applied to monitor implant osseointegration and stability using wireless technology in the near future. Figure 4: The cross-sectional TEM micrograph of the PAT biosensing capacitor with cells. Figure 3: Histograms of the distributions of breakdown field for the PAT biosensing capacitor with (MG-63 cell cultured for 72 h) and without cell cultures.