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What is the difference between these two words? Is there any difference? Are they used in different regions?

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Yes, they are both peak.

For me, 山顶 is more general word for peak. But 山巅 is more powerful, usually is used in the literature.

You can say 山顶 for a hill or a mountain, but you don't know if there are other higher 山顶s around. But 山巅 is supposed to be the highest among the nearby region.

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