Coach Kieran Crowley has moved Ange Capuozzo to fullback, with Pani coming in on the wing, and Tommaso Allan at flyhalf to face a Uruguay side which impressed in their 27-12 loss against France.
The two Garbisi brothers start, with Alessandro taking over from Stephen Varney at scrumhalf. The Cannone brothers also make the side, with Niccolo replacing lock Dino Lamb.
Prop Riccioni comes in for Simone Ferrari, while back row Sebastian Negri will make his 50th appearance for Italy.
Having won as expected against Namibia, and with New Zealand and France still to come, Italy can't afford to take the game with Uruguay lightly.
"We worked well during the week in Bourgoin," Crowley said. "We are in a World Cup, every game has its importance, its difficulties and its history.
"The preparation for the match against Uruguay was good. We will be focused on our performance."
Hosts France, New Zealand and Namibia are the other teams in Pool A.