One thing that the larger MDT's have vs LDT's and the smaller MDT;s, is better gearing in transmissions, along with 2 spd rear ends. These will allow one at times NOT to need 4wd to move a load backwards or forwards up hills.
MY Navistar for example, has the ability to move 30K up a 30% grade. My old dually dmax it was 20K up a 24% grade. UNLESS I was in 4 lo. This is with a 175/335 non turbo 7.3 vs a 320/660 turbo 6.6L. Gears can make a difference in little trucks too. My old 96 6.5td with a manual 5 sp, 4.10 gears and a NV4500 manual, could do 30% grade at 20K lbs. Better than the dmax! BUT, the dmax due to 300+hp, could out pull both trucks on a typical 3-4% freeway grade speed wise.
Another thing MDT's offer if you do a lot of slower steeper grade towing and moving, is 2 speed rear ends. You can have a 3.73 road drive gears, and 4.10 or 4.33 gears for low speed/steep grade maneuvering.
Since we are talking low speed maneuvering...yes, mdt's are generally speaking, setup better! or at least have the ability to do so.
As far as DW vs SW traction.....SW's do better than duals. This included in semi's super singles vs two dual tires with the same width contact patch. so a single 20" wide tire vs two 10" tires of the same/similar tread designs.
Also as noted, if you get a mdt, make sure it has a locker of some sort. I have a detroit no spin/locker. An air on/off style would be nicer, but I have hydraulic brakes. An air locker is not in my cards. The locker helps in low traction situations. As they have in my LDT trucks trucks too. I've got places in RWD with a locker that took 4wd with an open rear diff. With this in mind too....sometimes one does need a front driving axle to get thru a low traction situation....lockers alone do not help..this is a pretty small % of time.
My 02 on the subject.
Marty