Number eight Parisse, who returned from injury in the 16-9 defeat by Ireland, was replaced by Alessandro Zanni.
Hooker Leonardo Ghiraldini has not recovered from a thigh muscle injury and lock Quintin Geldenhuys takes over as captain.
Tommaso Benvenuti replaced Gonzalo Garcia at inside centre and prop Alberto De Marchi, who joined the squad this week as an injury replacement for Martin Castrogiovanni, could make his World Cup debut off the bench.
Italy cannot make the quarter-finals after losing to France and Ireland and beating Canada, but they would secure third place in the group by avoiding defeat against Romania.
Team: 1-Matias Aguero, 2-Andrea Manici, 3-Lorenzo Cittadini, 4-Quintin Geldenhuys (captain), 5-Josh Furno, 6-Francesco Minto, 7-Simone Favaro, 8-Alessandro Zanni; 9-Edoardo Gori, 10-Tommaso Allan, 11-Giovanbattista Venditti, 12-Tommaso Benvenuti, 13-Michele Capagnaro, 14-Leonardo Sarto, 15-Luke McLean.
Replacements: 16-Davide Giazzon, 17-Alberto De Marchi, 18-Dario Chistolini, 19-Valerio Bernabo, 20-Samuela Vunisa, 21-Guglielmo Palazzani, 22-Carlo Canna, 23-Enrico Bacchin.
(Reporting by Ed Osmond; Editing by David Goodman)
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