Alcohol consumption is linked to reduced bone mass and strength due to an imbalance in bone remodeling, characterized by decreased bone formation and an increased inflammatory response. Apical periodontitis affects the tissues surrounding the teeth and may also influence the systemic immune response by altering inflammatory marker levels. This systematic review examined how alcohol consumption affects the severity of experimental apical periodontitis in animal models. Following PRISMA guidelines, studies were sourced from three databases (PubMed, Scopus, and Web of Science) up to January 26, 2025. The included studies analyzed inflammation and/or bone resorption in animals with induced apical periodontitis, comparing alcohol-exposed groups to well-defined controls. Study quality was evaluated using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines and the risk of bias was analyzed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool. Of 135 screened records, 7 studies met the inclusion criteria. These studies were of moderate quality with a moderate risk of bias. Findings revealed that chronic alcohol consumption exacerbates inflammation and bone resorption in rats with experimental apical periodontitis, with effects increasing in a dose-dependent manner. The evidence suggests that chronic alcohol consumption amplifies the periapical inflammatory response in animal models, potentially accelerating apical periodontitis progression. These results highlight the need for further prospective studies to explore the broader implications of alcohol consumption in the context of apical periodontitis. This systematic review is registered on the International Prospective Register of Systematic Reviews (PROSPERO
CRD42024589226).