They bring in wing Kaine Robertson, scrum-half Pablo Canavosio, lock Carlo Del Fava and flanker Paul Derbyshire while Andrea Masi switches from wing to centre.
But both Del Fava and Derbyshire will be subject to late fitness checks after the forward duo picked up muscle injuries in pre-match training.
The pair impressed coach Nick Mallett after coming on as second-half substitutes in last week’s 46-20 defeat in France, contributing to a late rally in which Del Fava scored a try.
If they are not fit, second-row Marco Bortolami and back-rower Josh Sole will return to the starting side and Valerio Bernabo and Manoa Vosawai will come onto the bench.
Canavosio was chosen at scrum-half after coming on for the untidy Tito Tebaldi in Paris and scoring a late try. Robertson was recalled after starting the Azzurri’s opening 29-11 defeat in Ireland. Gonzalo Canale drops to the bench with Masi switched to outside centre.
Mallett had stuck with the same side for the previous three games, against France, Scotland and a 17-12 defeat by England.
Wales and Italy both go into match with two points gained from wins over Scotland and the loser could finish last if the Scots, who drew 15-15 with England last weekend, beat Ireland in Dublin.
Italian key play maker Craig Gower is expecting Wales to come out hard from the outset. “They will come out firing and it will be a big challenge for us,” he said.
“We have to do the basics right and see what comes. We are using the ball more than we used to. Ireland was a disappointing game for us in terms of moving the ball but we improved against England and Scotland and will be looking to create opportunities.”
He added: “We have changed from being a forward-based team; I do not want to give the ball away all the time but you have to be smart about the way you play and my job is to make it work, getting us in the right positions and playing a little bit. We are building as a team and we want to start getting results away from Rome.”
Italy: L McLean (Treviso); K Robertson (Viadana), A Masi (Racing-Metro), G Garcia (Treviso), Mirco Bergamasco (Stade Francais); C Gower (Bayonne), P Canavosio (Viadana); S Perugini (Bayonne), L Ghiraldini (Treviso), M Castrogiovanni (Leicester), C Del Fava (Viadana)/M Bortolami (Gloucester), Q Geldenhuys (Viadana), P Derbyshire (Padova)/J Sole (Viadana), Mauro Bergamasco (Stade Francais), A Zanni (Treviso).
Replacements: F Ongaro (Saracens), M Aguero (Saracens), M Bortolami (Gloucester)/V Bernabo (Roma), J Sole (Viadana)/M Vosawai (Parma), T Tebaldi (Gran Parma), R Bocchino (Rovigo), G Canale (Clermont Auvergne).
