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Objective:The restoration of the vertical dimension of occlusion (VDO) plays a critical role in functional rehabilitation and esthetic outcomes for edentulous patients. This study aimed to compare the clinical effectiveness of three prosthetic approaches—conventional, individualized, and CAD/CAM- milled complete dentures—in maintaining VDO, enhancing muscle activity, and improving patient satisfaction. Materials and Methods:Thirty edentulous patients (aged 55–75) were randomly divided into three groups (n = 10): Group A:Conventionalacrylicdentures Group B: Individualized dentures (phonetic and esthetic methods) Group C: CAD/CAM-milled digital dentures VDO was evaluated at five time points (baseline, post-insertion, 1, 3, and 6 months) using phonetic, esthetic, and mechanical techniques. Masseter EMG activity and patient satisfaction (5-point Likert scale) were also assessed. Statistical analysis included ANOVA and paired t-tests (p < 0.05). Results:Group C demonstrated the most stable VDO (mean variation: ±0.6 mm), followed by Group B (±1.2 mm) and Group A (±2.1 mm). EMG recordings showed significantly higher masticatory muscle activity in Groups B and C compared to Group A. Patient satisfaction scores were highest in Group C, particularly in aesthetics (4.8) and comfort (4.7), with statistically significant differences among groups (p < 0.01). Conclusion:CAD/CAM-milled dentures provide superior outcomes in VDO preservation, functional performance, and patient-reported satisfaction compared to conventional and individualized methods. The integration of digital technologies in complete denture fabrication enhances treatment predictability and patient-centered care. Clinicians are encouraged to adopt CAD/CAM or individualized approaches where appropriate to optimize long-term rehabilitation in edentulous patients.