Medical reformation process based on a human-centered approach requires universities to train healthcare professionals who are able to update knowledge and skills quickly, to adapt to new conditions, and be highly qualified and competitive specialists. The development of qualities that ensure communication with patients such as empathy is still of great importance. Empathy is an essential component in the professional activity of doctors of all specialties, therefore the fostering of empathy in students must be considered as inseparable component of future doctors’ training, a precondition for the successful independent practice. The article describes the concept of empathy, its types and components, considers the methods of forming empathy and analyzes some of them. Special attention is focused on the importance of developing empathy in the professional activity of doctors of all specialties. Empathy in a clinical context is the doctor's ability to understand the emotions of patients that can contribute to more thorough history taking and making more accurate diagnosis and as a consequence an effective personalized treatment plan. Clinical empathy includes the following components: 1 – the ability to understand the patients’ condition, their feelings (emotions); 2 – the ability to make a rapport with patients in order to understand their mental state, emotions, and check the accuracy of this understanding; 3 – the ability to act in a certain therapeutic way (taking into account the understanding of the patient's mental state). According to many researchers, empathy is a genetically determined property, strengthened or weakened by an individual's life experience that depends on certain individual personality traits, but scientists have proven that empathy can be fostered. According to the literature, a decline in the level of empathy is usually observed in the third year of medical training, when students begin clinical classes that require contact with patients. The researchers associate this decline with the deflation of the ideal image of a doctor and his / her professional role, which young people had when beginning their medical studies. The decrease in empathy after passing their first clinical classes can also be understood as a kind of protection mechanism in case of getting into various difficult and serious life-threatening situations. Other authors claim that there is no noticeable change in the level of empathy. Such ambiguous results arise can be explained by the fact that researchers use various evaluation methods and once again emphasize the relevance of these processes in modern clinical practice. Involvement of students in coming in contact with patients, and namely, during survey, examination and treatment; discussion of clinical cases with analysis of applied examination methods, treatment plan and prognosis helps to form and develop empathy, teaches communication with patients, which are quite important qualities of a doctor. When fostering empathy in students, one should not forget that during work the doctor encounters some stressful situations that are associated with the suffering of patients, and therefore, along with empathy, the doctor must possess stress resistance in order not to succumb to psychological deformation, emotional exhaustion and professional burnout, which in turn can negatively affect the quality of diagnosis and the effectiveness of patient treatment. It is worth noting that the achievements of modern medicine in the field of anesthesiological support, surgical intervention technologies, and patient care enable to harmonize this border between empathy and psychological deformation. Thus, during the professional training of doctors, educators and clinicians should pay special attention not only to the students’ acquisition of practical skills, but also to the development of empathy, the formation of stress resistance, the improvement of interpersonal communication both with colleagues and patients, and the development of skills, related to empathy in a broad sense as these aspects are one of the paramount tasks of medical education programs based on the biopsychosocial model of health.

Impaction and malposition of wisdom teeth and associated inflammatory and tumor-like complications occur in 35-50% of the able-bodied population. The operation of surgical extraction of the third molar of the mandible is indicated for these patients and this operation is one of the most common in surgical dentistry today.Alsoasignificant indication for wisdom teeth removaliscrowding of teeth. The classic operation of surgical wisdom tooth removal, even with careful planning, can be accompanied by different intraoperative and postoperative complications. Planning of removal of the third lower molar requires an individual approachwith mandatory consideration not only of the tooth position but also the topography of the causative tooth relative to the adjacent tooth and mandibular canal. Among the surgical procedures which are used to remove wisdom teeth, in addition to the classic surgery extraction, coronectomy and germectomy should be noted. The purpose of our study was to analyze the advantages and disadvantages of different techniques used for surgical extraction of impacted and malposition wisdom teeth. 208 operations regarding the removal of the third lower molars have been performedduring 2016-2019, of which surgical wisdom teeth removal were 213, coronectomies – 23 and germectomies – 29.Patients' ages ranged from 13 to 26 years. A germectomy was performed in 13-16 years old patient, usually at the stage of a fully formed tooth crown or at the beginning of root formation. The choice of surgery in patients with fully formed roots was dependent on the ratio of the root of the tooth and mandibular canal, which was evaluated after a preliminary computer examination, taking into account the complexity of the surgery and the prognosis of complications. Acoronectomy operation was performed with the close location of the roots of the wisdom tooth with the mandibular canal, taking into account the risk of the damage of lower alveolar nerve. Germectomy and surgery of wisdom teeth removal were performed according to the classical method with cutting of mucoperiostal flaps, preparation of bone, if necessary – separation of crown and roots with subsequent removal of the germ or tooth. The crown of wisdom tooth was separated with a coronectomy, (and cut in height with insufficient access) and the tooth crown was removed, leaving the roots in the jaw. Patients were observed on the next day after surgery, a week later, and as needed. The course of the postoperative period was evaluated: the presence of pain, swelling, complications. The duration of follow-up was up to 2 years. Conclusions: To the choice of surgery in patients with impaction and malposition of wisdom teeth should be approached in a differentiated manner, taking into account topographic and anatomical features, including the ratio of the roots of the teeth to the mandibular canal and assessing the risks of possible complications. Germectomy and coronectomy surgery can be recommended as surgery of choice for orthodontic indications in the treatment of patients with crowded teeth.

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The success of orthodontic treatment quite often depends on cooperation between the orthodontist and the dental surgeon. An integrated approach, including orthodontic treatment of dento-maxillary anomalies in combination with using the latest surgical techniques can provide quick defect correction of the maxillofacial region and ensure better stability of the results achieved; in most cases of teeth crowding, there is no alternative to the removal of the third lower molars. The purpose of this study was to analyze the surgical interventions performed on for surgical extraction of wisdom teeth for orthodontic reasons and the approach to their choice. Materials and methods. During 2016-2020 years, 158 patients were subjected to 241 surgical interventions for surgical extraction of the third lower molars for orthodontic reasons. We performed on 160 (66.4%) standard operations of atypical tooth extraction, 43 (17.8%) germectomies and 38 (15.8%) coronectomies. The patients' age ranged from 12 to 26 years. All patients were examined by applying the standard technique including orthopantomogram. In cases then it was impossible to clearly assess the ratio between the roots of the wisdom tooth and the mandibular canal as a result of the superposition of their projections on the obtained pantomograms, we used computed tomography. Based on the data obtained from the examination of the patient, the optimal safest surgical intervention was chosen for removal: the surgical extraction of the wisdom tooth, germectomy, or coronectomy. Conclusions: 1. Operations on surgical extraction of the lower wisdom teeth require mandatory planning and an individual approach to each patient based on a thorough preliminary examination. 2. In cases when it is impossible to clearly assess the ratio between the roots of the wisdom tooth and the mandibular canal as a result of overlapping their projections on the pantomograms, patients are recommended to undergo computed tomography, and then based on the assessment of CT findings to determine the topographic and anatomical relationship of the mandibular canal and roots. 3. The operation of surgical extraction of the lower wisdom tooth can be performed as a standard operation, germectomy can be recommended for patients with underdeveloped roots, coronectomy is a good option when the roots of the wisdom tooth are very close to the mandibular canal.