March 14 Italy prop Martin Castrogiovanni has recovered from broken ribs to take his place in the side to host Scotland on Saturday when both teams will be bidding to avoid the Six Nations wooden spoon.
The long-haired symbol of Italian rugby had been expected to miss the rest of the championship after being injured in the defeat by England last month but has battled back to fitness.
He is one of six changes from the side beaten by Wales last weekend but flyhalf Kristopher Burton keeps his place despite another poor display at the Millennium Stadium.
Edoardo Gori returns at scrumhalf for the match at Rome's Stadio Olimpico after recovering from a knee problem in the other major change.
Perennial wooden spoon contenders Italy and Scotland head into the final game with no points from their first four matches.
15-Andrea Masi, 14-Giovambattista Venditti, 13-Tommaso Benvenuti, 12-Gonzalo Canale, 11-Mirco Bergamasco, 10-Kristopher Burton, 9-Edoardo Gori, 8-Sergio Parisse (captain), 7-Robert Barbieri, 6-Alessandro Zanni, 5-Marco Bortolami, 4-Quintin Geldenhuys, 3-Martin Castrogiovanni, 2-Leonardo Ghiraldini, 1-Andrea Lo Cicero
Replacements: 16-Tommaso D'Apice, 17-Lorenzo Cittadini, 18-Joshua Furno, 19-Simone Favaro, 20-Manoa Vosawai, 21-Tobias Botes, 22-Giulio Toniolatti (Editing by Mark Meadows)