During implant surgery, which critical structure could be injured if the lingual plate of the posterior mandible is perforated and swelling occurs?

The critical structure that could be injured if the lingual plate of the posterior mandible is perforated and swelling occurs is the lingual artery. The lingual artery runs close to the lingual plate of the mandible and is responsible for supplying blood to the tongue and the floor of the mouth. When there is trauma to the lingual plate, particularly with perforation, the risk of damaging nearby anatomical structures increases, including the lingual artery. If swelling occurs due to the perforation, pressure may be exerted on the artery, leading to potential complications such as hemorrhage.

In contrast, while the inferior alveolar nerve and the external maxillary artery are important structures in the vicinity of the mandible, they are generally not affected as directly by perforations of the lingual plate. The carotid artery, situated more superiorly and laterally to the mandible, is located in a different anatomical plane and is less likely to be impacted in this context. Understanding the relationships between these structures and the potential consequences of surgical interventions is critical for ensuring patient safety during dental procedures involving implants.